支气管肺灌洗在先天性心脏病合并重症肺炎婴幼儿亚急诊手术中的应用  

Application of bronchoalveolar lavage in sub-emergency surgery for congenital heart disease infants with severe pneumonia

作　　者：王晓宇 张冲 刘建国 何飞 李迎 崔传玉 郭士勇 甄清 WANG Xiaoyu;ZHANG Chong;LIU Jianguo;HE Fei;LI Ying;CUI Chuanyu;GUO Shiyong;ZHEN Qing(Department of Cardiothoracic Surgery,Xuzhou Children's Hospital,Xuzhou Medical University,Xuzhou,Jiangsu 221006,China;Department of Respiratory,Xuzhou Children's Hospital,Xuzhou Medical University)

机构地区：[1]徐州医科大学附属徐州儿童医院心胸外科,江苏徐州221006 [2]徐州医科大学附属徐州儿童医院呼吸科

出　　处：《徐州医科大学学报》2021年第8期607-610,共4页Journal of Xuzhou Medical University

基　　金：徐州市科技局重点研发计划(KC18173)。

摘　　要：目的探讨支气管肺灌洗在先天性心脏病合并重症肺炎婴幼儿亚急诊手术中的诊疗价值。方法2016年12月至2019年12月徐州医科大学附属徐州儿童医院实施先天性心脏病合并重症肺炎婴幼儿亚急诊手术25例。随机数字表法分为观察组(12例)和对照组(13例),观察组在术中体外循环建立后实施支气管肺灌洗,对照组仅行常规手术。比较2组患儿术后呼吸机辅助通气时间、监护室留滞时间、感染指标及术后并发症情况。结果25例患儿均治愈出院,观察组患儿术后呼吸机辅助通气时间、监护室留滞时间短于对照组(P<0.05),肺部感染临床评分(CPIS)下降至6分以下时间及降钙素原(PCT)、白细胞计数(WBC)恢复正常时间短于对照组(P<0.05)。结论对于先天性心脏病合并重症肺炎接受体外循环亚急诊手术的婴幼儿,术中支气管肺灌洗有利于肺部感染控制,改善肺功能,可缩短术后呼吸机辅助通气时间和监护室留滞时间。Objective To evaluate the application of bronchoalveolar lavage in sub-emergency surgery for congenital heart disease infants with severe pneumonia.Methods A total of 25 congenital heart disease infants with severe pneumonia who were admitted to Xuzhou Children's Hospital,Xuzhou Medical University,from December 2016 to December 2019,were enrolled.According to the random number table method,they were randomly divided into two groups:an observation group(n=12)and a control group(n=13).The observation group received bronchopulmonary lavage after establishment of extracorporeal circulation,while the control group underwent routine surgery.Then,both groups were compared for the time of postoperative ventilator-assisted ventilation,the length of intensive care unit(ICU)stay,clinical pulmonary infection score(CPIS)and postoperative complications.Results All the patients were cured before discharge.Compared with the control group,the observation group presented decreases in the postoperative ventilator-assisted ventilation time and length of ICU stay(P<0.05),as well as the time that CPIS reduced below 6 scores,and the time that procalcitonin(PCT)and white blood cell count(WBC)return to the normal(P<0.05).Conclusions During extracorporeal circulation sub-surgery for congenital heart disease infants with severe pneumonia,bronchoalveolar lavage is conducive to lung infection control,and can ameliorate postoperative pulmonary function,reduce mechanical ventilation time and the length of ICU stay.

关 键 词：婴幼儿 先天性心脏病 重症肺炎 体外循环 支气管肺灌洗 

分 类 号：R726.5[医药卫生—儿科]