不同时机支气管镜灌洗术治疗小儿腺病毒肺炎的临床研究  

Clinical study of different bronchoscopic lavage timings in the treatment of adenovirus pneumonia in children

作　　者：谢冰[1] 刘春花[2] XIE Bing;LIU Chunhua(Children's Respiratory Area 1,Chenzhou No.1 People's Hospital,Chenzhou 423000,China;Department of Pediatrics,Chenzhou No.1 People's Hospital,Chenzhou 423000,China)

机构地区：[1]郴州市第一人民医院儿童呼吸一区,湖南郴州423000 [2]郴州市第一人民医院儿科,湖南郴州423000

出　　处：《中国医学物理学杂志》2022年第12期1569-1573,共5页Chinese Journal of Medical Physics

基　　金：郴州市科技计划项目(zdyf201959)。

摘　　要：目的:探讨不同时机支气管镜灌洗术治疗小儿腺病毒肺炎的临床应用价值。方法:选取行支气管镜灌洗术的腺病毒肺炎小儿62例,依据灌洗术进行时机,将灌洗前病程<10 d的小儿设为早期组(n=31),将灌洗前病程≥10 d的小儿设为晚期组(n=31)。评估并比较两组治疗效果,灌洗后临床相关指标,灌洗前和灌洗48 h后血气指标[荧光素与蛋白质结合比率(F/P)、动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))、血氧饱和度(SpO_(2))]、体征指标[心率(HR)、呼吸频率(RR)、平均动脉压(MAP)]水平及感染学相关指标[C反应蛋白(CRP)、白细胞计数(WBC)]水平,记录两组并发症发生情况。结果:早期组与晚期组腺病毒肺炎小儿治疗总有效率分别96.77%和80.65%(P<0.05);早期组灌洗后仍需机械通气小儿少于晚期组,且早期组热程、肺部啰音消失时间及住院时间均低于晚期组(P<0.05);灌洗后早期组PaO_(2)、F/P、SpO_(2)高于晚期组,PaCO_(2)低于晚期组(P<0.05);两组灌洗前后体征指标比较均无统计学意义(P>0.05),灌洗后早期组CRP、WBC水平均低于晚期组(P<0.05)。结论:于灌洗前病程在10 d以内行支气管镜灌洗术可一定程度提高对小儿腺病毒肺炎的治疗效果。Objective To explore the effect of the timing on the efficacy of bronchoalveolar lavage in children with adenovirus pneumonia.Methods According to the timing of bronchoscopic lavage,62 children receiving bronchoscopic lavage for adenovirus pneumonia were divided into early group(n=31,received bronchoscopic lavage within<10 d of the disease course)and late group(n=31,received bronchoscopic lavage within≥10 d of the disease course).The therapeutic effect and the clinical related indexes after lavage were evaluated.Before and after 48 h of lavage,blood gas indexes[fluorescein/protein binding ratio(F/P),partial pressure of arterial carbon dioxide(PaCO2),partial pressure of oxygen in arterial blood(PaO2),blood oxygen saturation(SpO2)],physical indexes[heart rate(HR),respiratory rate(RR),mean arterial pressure(MAP)]and infection analysis indicators[C-reactive protein(CRP),white blood cell count(WBC)]were evaluated and compared.The occurrences of complications in both groups were also recorded.Results The total response rate in early group was higher than that in late group(96.77%vs 80.65%,P<0.05).The number of cases undergoing mechanical ventilation after lavage in early group was less than that in late group,and the duration of fever,disappearance time of lung rale and hospital stay were shorter in early group(P<0.05).After lavage,early group had higher PaO2,F/P and SpO2,and lower PaCO2,CRP and WBC as compared with late group(P<0.05).There was no significant difference in physical signs between the two groups before and after lavage(P>0.05).Conclusion Receiving bronchoscopic lavage within<10 d of the disease course can improve treatment outcome of adenovirus pneumonia in children.

关 键 词：支气管镜灌洗术 小儿 腺病毒肺炎 病程 

分 类 号：R725.6[医药卫生—儿科]