纤维支气管镜灌洗术治疗不同病程小儿大叶性肺炎的疗效
| 作者: |
1张贺,
1刘晓萌,
1宋义琴,
1于海明,
1冀超玉,
2李会仙,
2崔丽茹
1 保定市儿童医院呼吸科(保定市儿童呼吸消化疾病临床研究重点实验室)，河北 保定 071000 2 保定市儿童医院新生儿科，河北 保定 071000 |
| 通讯: |
张贺
Email: zhh821016@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2020.07.017 |
| 基金: | 保定市科技计划项目(17ZF037)。 |
摘要
目的：探讨纤维支气管镜灌洗术治疗不同病程小儿大叶性肺炎的疗效。方法： 选取2017年1月至2019年2月在保定市儿童医院接受治疗的大叶性肺炎患儿96例，按随机数表法分为2组，对照组48例采用常规内科治疗，实验组48例在对照组基础上加用纤维支气管镜灌洗术治疗，根据实验组患儿病程，将其分为早期灌洗组(病程<7 d，n=23)和晚期灌洗组(病程≥7 d，n=25)。对比3组临床症状、治疗有效率、治疗前后肺功能指标、病原学检测情况。结果：治疗后，3组患儿治疗有效率比较差异有统计学意义(P<0.05)，其中早期灌洗组治疗有效率显著高于对照组(t=4.434，P=0.035)。3组治疗后，发热、咳嗽、肺部啰音消失时间和抗生素使用时间比较有差异(P<0.05)，其中早期灌洗组各指标时间均短于晚期灌洗组和对照组(P<0.05)。3组治疗后，最高呼气流量(peak expiratory flow，PEF)，第1秒用力呼气量(forced expiratory volume in 1 second，FEV1)，用力肺活量(forced vital capacity，FVC)比较有差异(P<0.05)，其中早期灌洗组PEF，FEV1，FVC均高于晚期灌洗组和对照组(P<0.05)。3组患儿经病原学检测发现病毒、细菌、支原体阳性率比较，差异无统计学意义(P>0.05)。结论：纤维支气管镜灌洗术用于治疗小儿大叶性肺炎疗效显著，可显著改善病程7 d内患儿的临床症状和肺功能。
关键词：
大叶性肺炎；小儿；纤维支气管镜灌洗术；病程
Curative effect of fibrobronchoscope lavage on lobar pneumonia in children with different disease courses
CorrespondingAuthor: ZHANG He Email: zhh821016@163.com
DOI: 10.3978/j.issn.2095-6959.2020.07.017
Foundation: This work was supported by the Baoding City Science and Technology Plan Project, China (17ZF037).
Abstract
Objective: To explore curative effect of fibrobronchoscope lavage on lobar pneumonia in children with different disease courses. Methods: Ninety-six children with lobar pneumonia who were treated in the hospital from January 2017 to February 2019 were enrolled. They were divided into two groups by random number table method, 48 cases in each group. The control group was treated with routine medical treatment, while experimental group was additionally treated with fibrobronchoscope lavage. According to disease courses of children in experimental group, they were divided into an early lavage group (disease courses shorter than 7 d, n=23) and a late lavage group (disease courses not shorter than 7 d, n=25). The clinical symptoms, response rate of treatment, pulmonary function indexes before and after treatment, and etiology detection were compared among the 3 groups. Results: After treatment, there were significant differences in response rate of treatment among the 3 groups (P<0.05). The response rate of treatment in the early lavage group was significantly higher than that in the control group (t=4.434, P=0.035). After treatment, there were significant differences in disappearance time of fever, cough and lung rale, and antibiotic usage time among the 3 groups (P<0.05). The time of all indexes in the early lavage group was shorter than that in the late lavage group and control group (P<0.05). After treatment, there were significant differences in peak expiratory flow (PEF), forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) among the 3 groups (P<0.05). PEF, FEV1 and FVC in the early lavage group were all higher than those in the late lavage group and the control group (P<0.05). The etiology detection found that there were no significant differences in positive rates of viruses, bacteria and mycoplasma among the 3 groups (P 0.05). Conclusion: The curative effect of fibrobronchoscope lavage is significant on pediatric lobar pneumonia, which can significantly improve clinical symptoms and pulmonary function of children with disease course within 7 d.
Keywords：
lobar pneumonia; child; fibrobronchoscope lavage; course of disease