小儿难治性MPP应用地塞米松联合糜蛋白酶纤支镜肺泡灌洗治疗的临床效果观察  

Observation on Clinical Effect of Fiberoptic Bronchoscopic Alveolar Lavage with Dexamethasone Combined with Chymotrypsin in the Treatment of Refractory MPP in Children

作　　者：王铁桥[1] 李伟涛[1] 肖大立[1] WANG Tieqiao;LI Weitao;XIAO Dali(Guangdong Women’s and Children’s Hospital,Guangzhou 510010,China)

机构地区：[1]广东省妇幼保健院,广东广州510010

出　　处：《中国医学创新》2021年第22期1-4,共4页Medical Innovation of China

基　　金：广东省医学科学技术研究基金(A2020432)。

摘　　要：目的:探讨小儿难治性肺炎支原体肺炎(MPP)应用地塞米松联合糜蛋白酶纤支镜肺泡灌洗治疗的临床效果。方法:选取2020年1-12月本院收治的85例难治性MPP患儿。将患儿随机分为试验组45例和对照组40例。两组患儿均给予止咳化痰、吸氧、抗感染、退热等基础治疗,对照组在此基础上给予生理盐水+地塞米松纤支镜肺泡灌洗,试验组在基础治疗上予以地塞米松联合糜蛋白酶纤支镜肺泡灌洗治疗。比较两组患儿的康复相关指标(退热时间、总发热时间、咳嗽消失时间、肺部体征消失时间);比较两组治疗前后肺功能检查指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、呼气峰流速(PEF)、25%用力呼气流速(FEF25)、75%用力呼气流速(FEF75)]及实验室检查指标[白细胞计数(WBC)、中性粒细胞(N)、C反应蛋白(CRP)]。结果:试验组退热时间、总发热时间、咳嗽消失时间、肺部体征消失时间均显著短于对照组,差异均有统计学意义(P<0.05)。治疗后,两组FVC、FEV1、PEF、FEF25、FEF75水平均较治疗前升高,且试验组均显著高于对照组,差异均有统计学意义(P<0.05)。治疗后,两组WBC、N、CRP水平均显著低于治疗前,且试验组均明显低于对照组,差异均有统计学意义(P<0.05)。结论:地塞米松联合糜蛋白酶纤支镜肺泡灌洗治疗小儿难治性MPP效果确切,可有效改善肺功能,减轻炎症反应,缩短症状康复时间。Objective:To explore the clinical effect of fiberoptic bronchoscopic alveolar lavage with Dexamethasone combined with Chymotrypsin in the treatment of refractory mycoplasma pneumoniae pneumonia (MPP) in children.Method:A total of 85 children with refractory MPP admitted to our hospital from January to December 2020 were selected.The children were randomly divided into experimental group (n=45) and control group (n=40).Children in both groups were given basic treatment,such as cough relieving phlegm,oxygen inhalation,anti-infection and antipyretic treatment,the control group was given Saline combined with Dexamethasone bronchoalveolar lavage on the basis of basic treatment,the experimental group was given Dexamethasone combined with Chymotrypsin bronchoalveolar lavage on the basis of basic treatment.The recovery related indicators (fever abatement time,total fever time,cough disappearance time,lung signs disappearance time) were compared between the two groups.Lung function indicators[forced vital capacity (FVC),forced expiratory volume in the first second (FEV1),peak expiratory flow rate (PEF),25% forced expiratory flow rate (FEF25),75% forced expiratory flow rate (FEF75)]and laboratory indicators[white blood cell count (WBC),neutrophil (N),C-reaction protein (CRP)]were compared between the two groups before and after treatment.Result:Fever abatement time,total fever time,disappearance time of cough and disappearance time of lung signs in experimental group were significantly shorter than those in control group,the differences were statistically significant (P<0.05).After treatment,the levels of FVC,FEV1,PEF,FEF25 and FEF75 in both groups were increased compared with before treatment,and the experimental group were significantly higher than those of the control group,the differences were statistically significant (P<0.05).After treatment,the levels of WBC,N and CRP in both groups were significantly lower than those of before treatment,and the experimental group were significantly lower than those of the control g

关 键 词：小儿难治性肺炎支原体肺炎 地塞米松 糜蛋白酶 纤支镜肺泡灌洗 

分 类 号：R725.6[医药卫生—儿科]