支气管肺泡灌洗术治疗儿童百日咳的效果观察  

Effect of bronchoalveolar lavage on pertussis in children

作　　者：黄广丽[1] 闫敬雪 Huang Guangli;Yan Jingxue(Department of Pediatric Critical Care Medicine,Handan Maternal and Child Health Hospital,Handan Hebei 056001,China)

机构地区：[1]邯郸市妇幼保健院儿童重症医学科,河北邯郸056001

出　　处：《遵义医科大学学报》2023年第8期783-787,共5页Journal of Zunyi Medical University

基　　金：河北省卫健委课题——河北省医学科学研究课题计划项目(NO:20191807)。

摘　　要：目的 探讨支气管肺泡灌洗术(BAL)治疗儿童百日咳的效果及对炎性因子水平的影响。方法 选取2020年6月—2022年5月我院儿科住院部收治的88例百日咳患儿,根据治疗方法的不同,将88例患儿分为两组,其中常规治疗组48例,均按照《中国儿童百日咳诊断及治疗建议》中的治疗方案治疗,支气管镜组40例,在常规治疗组的基础上行BAL。比较两组患儿的临床症状、血常规指标、炎性因子水平、免疫球蛋白水平、治疗后并发症发生率、住院时间及复发再住院率。结果 支气管镜组患儿的总有效率显著高于常规治疗组(χ^(2)=4.769,P=0.029)。治疗后,相比于常规治疗组,支气管镜组痉咳次数、痉咳后发紫次数、痉咳后呕吐次数均更少(P<0.05)。治疗后,相比于常规治疗组,支气管镜组WBC、LYN%、PLT、IL-6、CRP、TNF-α水平更低,IgG、IgA、IgM水平均更高(P<0.05)。两组患儿治疗后并发症发生率无统计学差异(P>0.05),支气管镜组住院时间、复发再住院率显著少于常规治疗组(P<0.05)。结论 常规治疗联合BAL对儿童百日咳的效果明显,能改善患儿的临床症状、机体炎症水平及免疫功能,但并未明显增加并发症的发生。Objective To investigate the effect of bronchoalveolar lavage in the treatment of pertussis in children and its effect on the level of inflammatory factors.Methods A retrospective study was conducted on 88 children with pertussis who were admitted to the pediatric inpatient department of our hospital from June 2020 to May 2022.According to different treatment methods,the patients were divided into two groups,including 48 cases in the conventional treatment group,all of which were treated according to the treatment protocol of“Chinese Children with pertussis Diagnosis and Treatment Recommendations”,and 40 cases in the bronchoscopy group,which performed BAL on the basis of the conventional treatment.The therapeutic effect,clinical symptoms,blood routine,levels of inflammatory factors,levels of immunoglobulin,incidence of complications after treatment,length of stay and recurrence rate of hospitalization were compared between the two groups.Results The total effective rate of children in the bronchoscopy group was significantly higher than that in the conventional treatment group(χ^(2)=4.769,P=0.029).After treatment,compared with the conventional treatment group,the number of spasmodic cough,purple after spasmodic cough and vomiting after spasmodic cough were less in the bronchoscopy group(P<0.05);moreover,the levels of WBC,LYN%,PLT,IL-6,CRP,TNF-αin the bronchoscopy group were lower,while levels of IgG,IgA,and IgM were higher(P<0.05).There was no significant difference in the incidence of complications between the two groups after treatment(P>0.05),and the length of hospital stay and recurrence rate in the bronchoscopy group was significantly lower than those in the conventional treatment group(P<0.05).Conclusion Conventional treatment combined with BAL has obvious effect on children with pertussis,which can improve the clinical symptoms,inflammation level and immune function of children,furthermore,it does not significantly increase the incidence of complications.

关 键 词：支气管肺泡灌洗术 儿童 百日咳 炎性因子 

分 类 号：R516.6[医药卫生—内科学]