雾化吸入乙酰半胱氨酸联合支气管镜在儿童肺炎支原体肺炎中的应用  

Application of atomized acetylcysteine inhalation combined with bronchoscopy in Mycoplasma pneumoniae pneumonia in children

作　　者：刘逸琳 孙静敏[2] 丁俊丽[2] Liu Yilin;Sun Jingmin;Ding Junli(The First School of Clinical Medicine,Anhui Medical University,Hefei230032;Dept of Pediatrics,The First Affiliated Hospital of Anhui Medical University,Hefei 230022)

机构地区：[1]安徽医科大学第一临床学院,合肥230032 [2]安徽医科大学第一附属医院儿科,合肥230022

出　　处：《安徽医科大学学报》2023年第3期515-518,522,共5页Acta Universitatis Medicinalis Anhui

基　　金：教育部重点实验室项目(编号:JK20214);国家级安徽医科大学大学生创新创业训练计划项目(编号:202110366001);安徽医科大学基础与临床合作研究提升计划项目(编号:2020xkjT027)。

摘　　要：目的回顾性分析雾化吸入乙酰半胱氨酸联合支气管镜灌洗治疗儿童肺炎支原体肺炎(MPP)的疗效。方法收集MPP住院患者120例,根据治疗方法不同,分为联合治疗组(43例)、雾化组(40例)及支气管镜组(37例)。其中,在接受常规治疗的同时,单以雾化吸入乙酰半胱氨酸的患儿纳入雾化组,单以支气管镜灌洗的患儿纳入支气管镜组,联合以上两种治疗方案的患儿纳入联合治疗组,比较各组临床疗效、影像学恢复情况及不良反应发生率。结果雾化组和支气管镜组总有效率无显著差异,均低于联合治疗组(P<0.05);三组肺部影像学好转率差异有统计学意义(P<0.05),联合治疗组最高,支气管镜组高于雾化组;联合治疗组与支气管镜组患儿发热、肺部啰音持续时间差异无统计学意义(P>0.05),均短于雾化组(P<0.05);雾化组和支气管镜组咳嗽持续时间、气促持续时间和住院时间差异无统计学意义(P>0.05),均长于联合治疗组(P<0.05);三组治疗后均未见严重不良反应,组间比较无显著差异。结论雾化吸入乙酰半胱氨酸联合支气管镜灌洗对儿童支原体肺炎治疗较单一治疗效果更好。Objective To retrospectively analyze the efficacy of aerosol inhalation of N-acetylcysteine(NAC)solution combined with bronchoalveolar lavage in children with Mycoplasma pneumoniae pneumonia(MPP).Methods A retrospective study was conducted on 120 children with MPP.According to different treatment methods,they were divided into combined treatment group(43 cases),atomization group(40 cases)and bronchoalveolar lavage group(37 cases).Among them,while receiving conventional treatment,children who were treated with aerosol inhalation of N-acetylcysteine alone were included in the atomization group,and those who were treated with bronchoalveolar lavage alone were included in the bronchoalveolar lavage group,and children treated with the combination of the above two treatments were included in the combined treatment group.The clinical efficacy,imaging recovery and incidence of adverse reactions were compared among all groups.Results Compared the total effective rate among the three groups,there was no significant difference between the atomization group and the bronchoalveolar lavage group(P>0.05),which were both lower than that of the combined treatment group(P<0.05);the difference in the improvement rate of lung imaging among the three groups was statistically significant(P<0.05),the combined treatment group was the highest,and the BAL group was higher than the atomization group;There was no significant difference in the duration of fever and pulmonary rales between the combined treatment group and the BAL group(P>0.05),which were shorter than those in the atomization group(P<0.05);There was no significant difference in duration of cough,shortness of breath and hospital stay between the atomization group and the BAL group(P>0.05),which were longer than those in the combined treatment group(P>0.05).There was no serious adverse reactions in the three groups.There was no significant difference in the three groups(P>0.05).Conclusion Compared with single treatment,N-acetylcysteine solution combined with bronchoalveolar lava

关 键 词：肺炎支原体肺炎 支气管镜灌洗 乙酰半胱氨酸 儿童 

分 类 号：R563.1[医药卫生—呼吸系统]