机构地区:[1]安徽省儿童医院/安徽医科大学附属省儿童医院/复旦大学附属儿科医院安徽医院呼吸科,合肥230051
出 处:《药学服务与研究》2021年第4期257-261,283,共6页Pharmaceutical Care and Research
摘 要:目的:观察难治性肺炎支原体感染(refractory mycoplasma pneumoniae pneumonia,RMPP)患儿应用大环内酯类抗生素联合纤支镜肺泡灌洗治疗的临床疗效。方法:选取安徽省儿童医院2018年3月-2020年3月收治的RMPP患儿60例,根据治疗方案不同分为对照组(n=25)和观察组(n=35)。对照组予以大环内酯类抗生素治疗,观察组在此基础上予纤支镜肺泡灌洗治疗,比较两组患儿的临床疗效及观察组患儿治疗前后纤支镜结果。结果:观察组的有效率高于对照组(94.29%vs 72.00%,P<0.01),观察组的热程、咳嗽好转时间、肺部啰音消失时间、影像学恢复时间、住院时间均短于对照组(P<0.01)。两组患儿治疗后的白细胞计数(WBC)、C-反应蛋白(CRP)、红细胞沉降率(ESR)、肿瘤坏死因子α(TNF-α)、白介素6(IL-6)、丙二醛(MDA)和凝血酶调节蛋白均较治疗前下降,观察组低于对照组;两组患儿的超氧化物歧化酶(SOD)水平升高,观察组高于对照组(P<0.01)。观察组末次肺泡灌洗纤支镜下发现黏膜充血水肿、滤泡状突起、纵行皱襞、痰栓、脓栓、炎性狭窄的比例低于首次肺泡灌洗(P<0.05,P<0.01)。两组患儿在治疗过程中均未出现明显不良反应。结论:大环内酯类抗生素联合纤支镜肺泡灌洗可有效治疗RMPP,促进其临床表现、影像学及实验室指标恢复正常,改善纤支镜下结果,值得临床推广。Objective:To observe the clinical efficacy of macrolide antibiotics combined with fiberoptic bronchoscopy alveolar lavage in treatment of refractory mycoplasma pneumoniae pneumonia(RMPP)in children.Methods:Sixty children with RMPP treated in Anhui Provincial Children’s Hospital from March 2018 to March 2020 were selected as research subjects,and were divided into the control group(n=25)and the observation group(n=35)according to different treatment regimens.The control group received macrolide antibiotics,and the observation group was treated with fiberoptic bronchoscopy alveolar lavage based on the treatment of the control group.The clinical effects were compared between the 2 groups,and results of fiberoptic bronchoscopy were observed in the patients of the observation group before and after treatment.Results:The effective rate of the observation group was higher than that of the control group(94.29%vs 72.00%,P<0.01).The heat course,cough improvement time,lung rale disappearing time,image recovery time,and hospitalization time of the observation group were all shorter than those of the control group(P<0.01).The white blood cell(WBC)counts,C-reaction protein(CRP),erythrocyte sedimentation rate(ESR),tumor necrosis factor-α(TNF-α),interleukin 6(IL-6),malondialdehyde(MDA)and thrombin regulatory protein of the 2 groups after treatment were all lower than those before treatment,with the observation group being lower than the control group.The level of superoxide dismutase(SOD)of the 2 groups increased and the observation group was higher than the control group(P<0.01).In the observation group,mucosal congestion and edema,follicular processes,longitudinal folds,sputum plugs,pus plugs and the proportion of inflammatory stenoses were all lower than those of the first lavage(P<0.05,P<0.01).There were no obvious adverse reactions in both groups in course of treatment.Conclusion:Fiberoptic bronchoscopy alveolar lavage combined with macrolide antibiotics could effectively treat RMPP,alleviate its clinical manifestations
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