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目的观察纤维支气管镜肺泡灌洗术对儿童大叶性肺炎治疗的临床效果。方法收集第四军医大学附属唐都医院2015年1至12月121例儿童大叶性肺炎的临床资料,分析应用纤维支气管镜肺泡灌洗术在临床疗效上的差异。结果 1病程≤7天的79例患儿,37例行纤维支气管镜肺泡灌洗术,1周后复查,治愈30例(占81.08%),42例对照组中治愈23例(占54.76%);病程>7天的42例患儿,22例行纤维支气管镜肺泡灌洗术,1周后复查,治愈17例(占77.27%),20例对照组中治愈11例(占55.00%);2121例患儿静脉血中肺炎支原体(M P)阳性10例(8.26%),而59例行纤维支气管镜肺泡灌洗术患儿的肺泡灌洗液(BALF)中MP阳性者为47例(79.66%);3病程在1周内的患儿接受纤维支气管镜肺泡灌洗术,其住院时间、热程均较对照组缩短(t值分别是2.394和2.101,均P<0.05),肺部病变治愈率明显优于对照组(χ2=6.171,P<0.05);而病程超过1周的患儿差异并无统计学意义。结论在大叶性肺炎患儿中,早期进行纤维支气管镜肺泡灌洗术治疗,可以有效缩短热程及住院天数,提高治愈率。检测BALF可提高MP的阳性检出率。
Objective To observe the clinical effect of bronchofibroscopy lavage on treatment of lobar pneumonia in children. Methods The clinical data of 121 cases of lobar pneumonia in children from January to December 2015 at Tangdu Hospital affiliated to the Fourth Military Medical University were collected to analyze the difference in the clinical efficacy of bronchoalveolar lavage. Results A total of 79 children with disease ≤ 7 days, 37 patients underwent bronchoalveolar lavage, and one week later, 30 cases were cured (81.08%) and 23 cases (54.76%) were cured in 42 cases. ; 42 cases were treated with fiberoptic bronchoscopy for alveolar lavage in 22 days, 17 cases were cured (77.27%) and 11 cases (55.00%) were cured in 20 cases. 2,121 cases of children Mycoplasma pneumoniae in blood (MP) 10 cases were positive (8.26%), while 59 routine bronchoscopy children alveolar lavage fluid (BALF) was positive in 47 cases of MP (79.66 %); 3 patients within 1 week of course of disease underwent bronchofulmonary bronchoscopy lavage, the length of hospital stay, heat stroke were shorter than the control group (t = 2.394 and 2.101, P <0.05), lung disease The cure rate was significantly better than that of the control group (χ2 = 6.171, P <0.05), while there was no significant difference in children with the course of more than 1 week. Conclusions In children with lobar pneumonia, bronchoalveolar lavage therapy can be shortened in the early stage, which can shorten the heat stroke and hospital stay, and improve the cure rate. Detection of BALF can increase the positive detection rate of MP.