基于倾向性评分匹配法评估Olympus电子支气管镜联合Storz硬质支气管镜治疗多发性支气管异物的临床疗效  

Effect of Olympus Electronic Bronchoscope Combined with Storz Rigid Bronchoscope on Treatment of Multiple Bronchial Foreign Bodies Evaluated by Propensity Score Matching Method

作　　者：吴鸣镝 张玉峰 WU Mingdi;ZHANG Yufeng(Endoscopy Center,Wuhan Pulmonary Hospital/Wuhan Tuberculosis Prevention and Treatment Center,Wuhan 430000,China;Department of Otolaryngology,Wuhan Children′s Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430000,China)

机构地区：[1]武汉市肺科医院武汉市结核病防治所内镜中心,武汉430000 [2]华中科技大学同济医学院附属武汉市儿童医院耳鼻喉科,武汉430000

出　　处：《医学综述》2023年第19期4003-4007,共5页Medical Recapitulate

摘　　要：目的基于倾向性评分匹配法(PSM)评估Olympus电子支气管镜联合Storz硬质支气管镜治疗多发性支气管异物的临床疗效。方法回顾性分析2018年1月至2022年12月武汉市肺科医院和华中科技大学同济医学院附属武汉市儿童医院收治的187例多发性支气管异物患儿的临床资料,依据治疗方法不同分为对照组(101例)和观察组(86例),其中对照组行Storz硬质支气管镜治疗,观察组行Olympus电子支气管镜联合Storz硬质支气管镜治疗。应用SPSS 26.0软件对患者进行PSM匹配,以获取组间协变量均衡的样本。比较匹配后两组患儿咳嗽消失时间、啰音消失时间、手术时间、脉搏血氧饱和度(SpO_(2))、SpO_(2)下降次数、呼吸频率及并发症发生率。结果PSM匹配前,两组患儿性别、异物位置、异物类型分布比较差异无统计学意义(P>0.05),但观察组患儿年龄大于对照组(P<0.01),病程小于对照组(P<0.01)。经PSM 1∶1匹配后,共有48对匹配成功,匹配后两组患儿性别、年龄、病程、异物位置、异物类型分布比较差异无统计学意义(P>0.05)。PSM匹配后,观察组患儿咳嗽消失时间、啰音消失时间均短于对照组[(3.48±0.55)d比(4.26±0.56)d、(4.50±0.58)d比(5.33±0.60)d](P<0.01)。观察组患儿手术时间、SpO_(2)下降次数少于对照组[(6.1±1.8)min比(13.2±2.0)min、(3.5±0.7)次比(10.5±1.0)次](P<0.01),呼吸频率低于对照组[(22±4)次/min比(29±4)次/min](P<0.01),SpO_(2)高于对照组(0.967±0.022比0.911±0.064)(P<0.01)。观察组患儿并发症总发生率低于对照组[6.25%(3/48)比20.83%(10/48)](χ^(2)=4.360,P=0.037)。结论采取PSM进行匹配可提高非随机患者一般资料的组间协变量均衡性。Olympus电子支气管镜联合Storz硬质支气管镜治疗可有效改善多发性支气管异物患儿各种临床症状,减少并发症发生。Objective To evaluate the clinical efficacy of Olympus electronic bronchoscope combined with Storz rigid bronchoscope in the treatment of multiple bronchial foreign bodies by propensity score matching(PSM).Methods The clinical data of 187 children with multiple bronchial foreign bodies admitted to Wuhan Pulmonary Hospital and Wuhan Children′s Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from Jan.2018 to Dec.2022 were retrospectively analyzed.According to different treatment methods,they were divided into a control group(101 cases)and an observation group(86 cases).The control group was treated with Storz rigid bronchoscopy,and the observation group was treated with Olympus electronic bronchoscopy combined with Storz rigid bronchoscopy.SPSS 26.0 software nearest matching method was used for PSM of patients to obtain covariate balanced samples between groups.The time of cough disappearance and rales disappearance,operation time,pulse oxygen saturation(SpO_(2)),SpO_(2) drop times,respiratory rate and complication rate were compared between the two groups after matching.Results Before PSM matching,there was no significant difference in gender,foreign body location and foreign body type distribution between the two groups(P>0.05),but the observation group was older than the control group(P<0.01),and the disease course was shorter than the control group(P<0.01).After PSM 1∶1 matching,a total of 48 pairs were successfully matched,and there was no statistical significance in gender,age,course of disease,foreign body location and foreign body type distribution between the two groups after matching(P>0.05).After PSM matching,the disappearance time of cough and rales in the observation group was shorter than that in the control group[(3.48±0.55)d vs(4.26±0.56)d,(4.50±0.58)d vs(5.33±0.60)d](P<0.01).Operation time and SpO_(2) drop times were less in the observation group than in the control group[(6.1±1.8)min vs(13.2±2.0)min,(3.5±0.7)times vs(10.5±1.0)times](P<0.01

关 键 词：多发性支气管异物 患儿 倾向性评分匹配法 电子支气管镜 硬质支气管镜 

分 类 号：R562.2[医药卫生—呼吸系统]