支气管肺泡灌洗联合局部用药治疗儿童重症肺炎支原体肺炎的疗效及CT影像学特征变化  

Efficacy of Bronchoalveolar Lavage Combined with Topical Medication in the Treatment of Severe Mycoplasma Pneumoniae Pneumonia in Children and Changes of CT Imaging Features

作　　者：吴长生 刘祥蕾 杨林风 朱峰 WU Changsheng;LIU Xianglei;YANG Linfeng;ZHU Feng(Department of Pediatric Critical Care Medicine,Suzhou Hospital of Anhui Medical University/Suzhou Municipal Hospital,Suzhou 234000,China)

机构地区：[1]安徽医科大学附属宿州医院/宿州市立医院儿童重症医学科,安徽宿州234000

出　　处：《药物生物技术》2024年第5期533-537,共5页Pharmaceutical Biotechnology

基　　金：皖科社秘基金项目([2023]310号)。

摘　　要：探究支气管肺泡灌洗联合局部用药治疗儿童重症肺炎支原体肺炎(MPP)的疗效,并分析其CT影像学特征变化情况。收集2021年8月—2023年4月医院儿童重症医学科收治的重症MPP患儿120例,按随机数字表法并根据入院顺序分为对照组(n=60)和观察组(n=60)。对照组予以常规对症治疗,观察组在对照组治疗基础上予以支气管肺泡灌洗联合布地奈德局部用药,两组均治疗2周。对两组临床总有效率、临床指标、肺功能指标、炎性因子指标、胸部CT影像学特征变化及不良反应进行比较。采用不同方案治疗后,观察组临床总有效率(91.67%)显著高于对照组(76.67%)(P<0.05),发热消失时间(3.22±1.19)d、咳嗽缓解时间(5.08±1.37)d、肺部啰音消失时间(6.64±1.31)d以及住院时间(11.91±2.63)d均显著短于对照组[(5.07±1.63)d、(7.44±1.80)d、(9.45±1.57)d、(15.03±3.48)d](P<0.05);治疗后,观察组肺功能指标FEV1、FVC、PEF分别达到(1.79±0.34)L、(2.42±0.55)L、(4.75±0.59)L/s,较对照组更高(P<0.05);治疗后,观察组炎性因子指标CRP、PCT、IL-6分别达到(7.91±2.04)mg/L、(0.33±0.12)μg/L、(20.86±4.20)ng/L,较对照组更低(P<0.05);治疗后,两组CT影像学特征均发生了显著变化,且观察组优于对照组(P<0.05);但观察组不良反应发生率(15.00%)显著高于对照组(P<0.05)。支气管肺泡灌洗联合局部用药治疗儿童重症MPP疗效显著,可有效缓解患儿临床症状,增强其肺功能,下调炎性因子水平,同时患儿胸部CT影像学特征得到明显改善,但尚需注意支气管镜的使用。The aim of this study was to explore the efficacy of bronchoalveolar lavage combined with local medication in the treat-ment of severe mycoplasma pneumoniae pneumonia(MPP)in children,and analyze the changes of CT imaging features.120 children with severe MPP admitted to Department of Pediatric Intensive Care Medicine of the Hospital from August 2021 to April 2023 were collected and divided into control group(n=60)and observation group(n=60)according to the order of admission by random number table method.The control group was given conventional symptomatic treatment,and the observation group was given bron-choalveolar lavage combined with topical medication of budesonide on the basis of the control group.Both groups were treated for 2 weeks.The total clinical effective rate,clinical indicators,pulmonary function indicators,inflammatory factors,chest CT imaging features and adverse reactions were compared between the two groups.After different regimens for treatment,the total clinical effec-tive rate in observation group(91.67%)was significantly higher than that in control group(76.67%)(P<0.05),and the disap-pearance time of fever,remission time of cough,disappearance time of pulmonary rales and hospital stay with(3.22±1.19)d,(5.08±1.37)d,(6.64±1.31)d and(11.91±2.63)d were significantly shorter than(5.07±1.63)d,(7.44±1.80)d,(9.45±1.57)d and(15.03±3.48)d in control group(P<0.05).After treatment,the pulmonary function indicators of FEV 1,FVC and PEF in observation group were(1.79±0.34)L,(2.42±0.55)L and(4.75±0.59)L/s,which were higher than those in control group(P<0.05).The inflammatory factors of CRP,PCT and IL-6 in observation group after treatment were(7.91±2.04)mg/L,(0.33±0.12)μg/L and(20.86±4.20)ng/L,which were lower than those in control group(P<0.05).After treatment,the CT imaging features of both groups were significantly changed,and the features were better in observation group compared to control group(P<0.05).However,the incidence of adverse reactions in observation group(15.00%)was signifi

关 键 词：支气管镜 肺泡灌洗 布地奈德 儿童 重症 肺炎支原体肺炎 CT 影像学特征 

分 类 号：R563.1[医药卫生—呼吸系统]