支气管镜介入术联合快速现场评价技术在儿童难治性肺病中的应用价值  

Application value of bronchoscopic intervention combined with on-site evaluation technology in children with refractory pulmonary diseases

作　　者：肖生平[1] 王桂兰[1] 刘翔腾[1] 黄娟[1] 邓坤仪[1] 谭南[1] 米贤军[1] XIAO Sheng-ping;WANG Gui-lan;LIU Xiang-teng;HUANG Juan;DENG Kun-yi;TAN Nan;MI Xian-jun(Department of Pediatrics,Boai Hospital of Zhongshan,Zhongshan 528400,Guangdong,China)

机构地区：[1]中山市妇幼保健院、中山市博爱医院儿科,广东中山528400

出　　处：《广东医学》2023年第11期1346-1350,共5页Guangdong Medical Journal

基　　金：广东省医学科学技术研究基金项目(A2020566)。

摘　　要：目的 探讨支气管镜介入术联合快速现场评价(rapid on-site evaluation, ROSE)技术应用到儿童难治性肺病中的意义。方法 选取2020年7月1日至2022年3月31日在儿科诊断难治性肺病的184例患儿纳入研究,对照组86例,用支气管镜介入术获取标本,进行常规检验,指导诊疗;试验组98例用支气管镜介入术联合ROSE诊疗,采集两组一般情况、确诊情况、抗生素使用率、使用时间、住院时间、住院费用等,分析组间差异。结果 两组确诊时间中位数差异有统计学意义(Z=2.88,P=0.004)。两组抗生素使用比例差异无统计学意义(χ^(2)=0.19,P=0.66),使用时间差异有统计学意义(Z=3.09,P=0.002)。两组住院时间中位数差异有统计学意义(Z=2.05,P=0.04),费用差异有统计学意义(Z=3.02,P=0.002)。结论 支气管镜介入术联合ROSE应用到疑难肺病中,可缩短确诊时间,缩短抗生素使用时间,缩短住院时间,减少费用,无法降低抗生素使用率。Objective To explore the significance of bronchoscopic intervention combined with rapid on-site evaluation(ROSE)in the diagnosis and treatment in children with refractory pulmonary disease.Methods A total of 184 children diagnosed with refractory pulmonary diseases from July 1,2020,to March 31,2022,were included in the study.The control group comprised 86 patients who underwent bronchoscopic intervention to obtain specimens for routine examination and guidance in diagnosis and treatment.The experimental group included 98 patients who underwent bronchoscopic intervention combined with ROSE for diagnosis and treatment.Data were collected,including general conditions,diagnosis status,antibiotic usage rate,duration of antibiotic use,length of hospital stay,and hospitalization costs,and were analyzed for differences between the two groups.Results There was a statistically significant difference in the median time of diagnosis between the two groups(Z=2.88,P=0.004).There was no statistically significant difference in the proportion of antibiotic usage between the two groups(X^(2)=0.19,P=0.66),but there was a statistically significant difference in the duration of antibiotic use(Z=3.09,P=0.002).There was a statistically significant difference in the median length of hospital stay between the two groups(Z=2.05,P=0.004),as well as in hospitalization costs(Z=3.02,P=0.002).Conclusion Bronchoscopic intervention combined with ROSE technology can shorten the time of diagnosis,days of antibiotic use,the hospital stay and cost,but cannot reduce the rate of antibiotic use.

关 键 词：儿童难治性肺病 支气管镜介入术 快速现场评价 

分 类 号：R725.6[医药卫生—儿科] R729[医药卫生—临床医学]