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纤维支气管镜早期治疗对支原体肺炎合并气道黏液阻塞患儿的疗效观察

[Efficacy of early treatment via fiber bronchoscope in children with Mycoplasma pneumoniae pneumonia complicated by airway mucus obstruction].

作者信息

Cao Li-Jie, Liu Jian-Hua, Shuai Jin-Feng, Niu Bo, Lu Su-Kun, Huang Kun-Ling

机构信息

Second Department of Respiration, Children′s Hospital of Hebei Province, Shijiazhuang 050031, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2018 Apr;20(4):298-302. doi: 10.7499/j.issn.1008-8830.2018.04.009.

Abstract

OBJECTIVE

To study the efficacy of early treatment via fiber bronchoscope in children with Mycoplasma pneumoniae pneumonia (MPP) complicated by airway mucus obstruction.

METHODS

According to the time from admission to the treatment via fiber bronchoscope, the children with MPP who were found to have airway mucus obstruction under a fiber bronchoscope were randomly divided into early intervention group (≤3 days; n=40) and late intervention group (>3 days; n=56). The two groups were compared in terms of clinical data and imaging recovery.The children were followed for 1-3 months.

RESULTS

Of the 96 children, 38 were found to have the formation of plastic bronchial tree, among whom 10 were in the early intervention group and 28 were in the late intervention group (P=0.01). Compared with the late intervention group, the early intervention group had a shorter duration of fever, length of hospital stay, and time to the recovery of white blood cell count and C-reactive protein (P<0.05), as well as a higher atelectasis resolution rate (P<0.05). Compared with the late intervention group, the early intervention group had a higher percentage of children with a ≥ 60% absorbed area of pulmonary consolidation at discharge. After 3 months of follow-up, the early intervention group had a higher percentage of children with a ≥ 90% absorbed area of pulmonary consolidation than the late intervention group (80% vs 55%; P=0.01), and the early intervention group had a lower incidence rate of atelectasis than the late intervention group (P<0.05).

CONCLUSIONS

Early treatment via fiber bronchoscope can shorten the course of the disease and reduce complications and sequelae in MPP children with airway mucus obstruction.

摘要

目的

探讨纤维支气管镜早期介入治疗对支原体肺炎(MPP)合并气道黏液阻塞患儿的疗效。

方法

将纤维支气管镜检查发现有气道黏液阻塞的MPP患儿,按入院至行纤维支气管镜治疗的时间,随机分为早期干预组(≤3天;n = 40)和晚期干预组(>3天;n = 56)。比较两组的临床资料及影像学恢复情况。对患儿随访1 - 3个月。

结果

96例患儿中,38例出现塑型性支气管炎,其中早期干预组10例,晚期干预组28例(P = 0.01)。与晚期干预组比较,早期干预组发热持续时间、住院时间、白细胞计数及C反应蛋白恢复时间均较短(P<0.05),肺不张消散率较高(P<0.05)。与晚期干预组比较,早期干预组出院时肺部实变吸收面积≥60%的患儿比例更高。随访3个月后,早期干预组肺部实变吸收面积≥90%的患儿比例高于晚期干预组(80% vs 55%;P = 0.01),且早期干预组肺不张发生率低于晚期干预组(P<0.05)。

结论

纤维支气管镜早期介入治疗可缩短MPP合并气道黏液阻塞患儿的病程,减少并发症及后遗症。

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