经纤维支气管镜肺泡灌洗联合布地奈德局部给药治疗对重症肺炎患儿肺功能与炎症因子的影响  

Effect of fiberoptic bronchoalveolar lavage combined with budesonide topical administration on pulmonary function,inflammatory factors and effects in children with severe pneumonia

作　　者：郭太勇 毛平华 李荣华 GUO Taiyong;MAO Pinghua;LI Ronghua(Department of Pediatrics,Yongzhou Third People's Hospital,Yongzhou,Hu'nan,425000,China)

机构地区：[1]永州市第三人民医院儿科,湖南永州425000

出　　处：《当代医学》2025年第1期28-32,共5页Contemporary Medicine

摘　　要：目的探讨经纤维支气管镜肺泡灌洗联合布地奈德局部给药治疗对重症肺炎(severe pneumonia,SP)患儿肺功能、炎症因子的影响。方法选取2020年3月至2023年3月永州市第三人民医院收治的60例SP患儿作为研究对象,按照随机数字表法分为对照组与观察组,每组30例。对照组实施常规治疗,观察组在对照组基础上实施经纤维支气管镜肺泡灌洗联合布地奈德局部给药治疗。比较两组临床指标、肺功能情况[用力肺活量(forced vital capacity,FVC)、呼气峰值流量(peak expiratory flow,PEF)、最大呼气中期流量(maximal midexpiratory flow,MMEF)]、炎症因子指标[肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、C-反应蛋白(C-reactive protein,CRP)、白细胞介素-6(interleukin-6,IL-6)、白细胞介素-2(interleukin-2,IL-2)]、临床疗效、并发症发生情况及帕金森病评分量表(unified Parkinson's disease rating scale,UPDRS)评分。结果观察组退热时间、住院时间、咳嗽持续时间、肺啰音维持时间均短于对照组,影像学好转率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组FVC、PEF、MMEF均大于治疗前,且观察组大于对照组,差异有统计学意义(P<0.05)。治疗后,两组TNF-α、CRP、IL-6水平均低于治疗前,IL-2水平高于治疗前,且观察组TNF-α、CRP、IL-6水平均低于对照组,IL-2水平高于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。两组并发症发生率比较差异无统计学意义。治疗后,两组UPRDSⅠ、UPRDSⅡ、UPRDSⅢ评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论经纤维支气管镜肺泡灌洗联合布地奈德局部给药治疗SP患儿疗效显著,能缩短患儿住院时间,减轻临床症状,改善肺功能情况,降低炎症反应,值得临床推广应用。Objective To investigate the effect of fiberoptic bronchoalveolar lavage combined with budesonide topical administration on pulmonary function and inflammatory factors in children with severe pneumonia.Methods 60 children with severe pneumonia admitted to Yongzhou Third People's Hospital from March 2020 to March 2023 were selected as the research subjects,and they were divided into the control group and the observation group according to the random number table method,with 30 cases in each group.The control group received conventional therapy,and the observation group underwent flberoptic bronchoalveolar lavage combined with budesonide topical.Clinical indicators,pulmonary function(forced vital capacity[FVC],peak expiratory flow[PEF],maximal midexpiratory flow[MMEF]),inflammatory factor index(tumor necrosis factor-α[TNF-α],C-reactive protein[CRP],interleukin-6[IL-6],interleukin-2[IL-2]),clinical efficacy,complication and unified Parkinson's disease rating scale(UPDRS)score were compared between the two groups.Results The time of fever remission,hospital stay,cough duration and pulmonary rales in the observation group were shorter than those in the control group,and the rate of imaging improvement was higher than that in the control group,the differences were statistically significant(P<0.05).After treatment,FVC,PEF and MMEF of the two groups were larger than before treatment,and the observation group was larger than the control group,the differences were statistically significant(P<0.05).After treatment,the levels of TNF-α,CRP and IL-6 of the two groups were lower than before treatment,and the levels of IL-2 were higher than before treatment,and the levels of TNF-α,CRP and IL-6 in the observation group were lower than those in the control group,and the level of IL-2 were higher than that in the control group,the differences were statistically significant(P<0.05).The total effective rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).

关 键 词：重症肺炎 纤维支气管镜肺泡灌洗 布地奈德 肺功能 炎症因子 

分 类 号：R725.6[医药卫生—儿科]