纤维支气管镜检查及肺泡灌洗治疗在儿童反复喘息性疾病诊治中的应用效果  

Application effect of fiberoptic bronchoscopy and alveolar lavage therapy in diagnosis and treatment of recurrent wheezing disorders in children

作　　者：洪爽 卢宏志 田大伟 于海心 杨召川[2] HONG Shuang;LU Hongzhi;TIAN Dawei;YU Haixin;YANG Zhaochuan(Department of Pediatrics,Qinhuangdao Maternal and Child Health Care Hospital in Hebei Province,Qinhuangdao,Hebei,066000;Department of Child Healthcare,the Affiliated Hospital of Qingdao University,Qingdao,Shandong,266003)

机构地区：[1]河北省秦皇岛市妇幼保健院儿科,河北秦皇岛066000 [2]青岛大学附属医院儿童保健科,山东青岛266003

出　　处：《实用临床医药杂志》2024年第24期44-47,52,共5页Journal of Clinical Medicine in Practice

基　　金：山东省自然科学基金面上项目(ZR2022MH030);河北省秦皇岛市科技局2023年度市级自筹项目(202301A242)。

摘　　要：目的探讨纤维支气管镜检查及肺泡灌洗治疗在儿童反复喘息性疾病诊治中的应用效果。方法选取151例反复喘息性疾病患儿为研究对象,并根据不同诊疗方法分为对照组(n=84)与研究组(n=67)。对照组行常规诊断与治疗,研究组行纤维支气管镜检查联合肺泡灌洗治疗。比较2组患儿的症状消失时间与住院时间。比较2组肺功能[第1秒用力呼气容积(FEV_(1))、第1秒用力呼气容积与用力肺活量比值(FEV_(1)/FVC)及呼气峰流速(PEF)]、呼出气一氧化氮(FeNO)、血清炎症介质水平[C反应蛋白(CRP)、降钙素原(PCT)和白细胞(WBC)]以及临床疗效。结果研究组喘息和肺部啰音消失时间、住院时间短于对照组,差异有统计学意义(P<0.05)。治疗后,2组FEV_(1)、FEV_(1)/FVC、PEF高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05)。治疗后,2组FeNO以及CRP、PCT、WBC低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05)。研究组临床治疗总有效率为94.03%,高于对照组的77.38%,差异有统计学意义(P<0.05)。结论纤维支气管镜检查及肺泡灌洗治疗在儿童反复喘息性疾病诊治中的应用效果较好,可有效缓解患儿症状,缩短住院时间,改善其肺功能、FeNO以及血清炎症介质水平。Objective To investigate the application effect of fiberoptic bronchoscopy and alveolar lavage therapy in the diagnosis and treatment of recurrent wheezing diseases in children.Methods A total of 151 children with recurrent wheezing diseases were enrolled,and divided into control group(n=84)and study group(n=67)based on different diagnostic and therapeutic methods.The control group received conventional diagnosis and treatment,while the study group underwent fiberoptic bronchoscopy combined with alveolar lavage therapy.The time to resolution of symptoms and length of hospital stay were compared between the two groups.Additionally,lung function[forced expiratory volume in 1 second(FEV_(1)),FEV_(1)/forced vital capacity(FEV_(1)/FVC)and peak expiratory flow(PEF)],exhaled nitric oxide(FeNO),serum inflammatory mediator levels[C-reactive protein(CRP),procalcitonin(PCT)and white blood cell(WBC)count]and clinical efficacy were compared.Results The absence time of wheezing and pulmonary rales and hospital stay in the study group were significantly shorter than those in the control group(P<0.05).After treatment,FEV_(1),FEV_(1)/FVC and PEF in two groups were significantly higher than before treatment,and the study group was significantly higher than the control group(P<0.05).After treatment,FeNO,CRP,PCT and WBC in two groups were significantly lower than before treatment,and the study group was significantly lower than the control group(P<0.05).The total effective rate of the study group was 94.03%,which was significantly higher than 77.38%of the control group(P<0.05).Conclusion Fiberoptic bronchoscopy and alveolar lavage are effective in the diagnosis and treatment of recurrent asthmatic diseases in children,which can effectively relieve symptoms,shorten hospital stay,and improve lung function,FeNO and serum inflammatory mediators.

关 键 词：纤维支气管镜检查 肺泡灌洗治疗 儿童反复喘息性疾病 血清炎症介质 肺功能 

分 类 号：R725.6[医药卫生—儿科] R446[医药卫生—临床医学] R256.12