支气管镜术在儿童肺炎支原体肺炎伴气道内黏液栓治疗中应用

邱在军 林婷 邱荣军 吴丹遐 陈健青

【摘要】 目的：分析支氣管镜术在儿童肺炎支原体肺炎伴气道内黏液栓治疗中的应用效果。方法：选取2019年1月-2020年10月于本院接受治疗的90例儿童肺炎支原体肺炎伴气道内黏液栓患儿作为研究对象，采用抽签法将其分为观察组和对照组，各45例。对照组采用常规治疗，观察组在对照组基础上采用支气管镜术治疗。对比两组临床症状消失时间，治疗前和治疗7 d后炎症反应指标[白介素-6（IL-6）、C反应蛋白（CRP）、肿瘤坏死因子α（TNF-α）]及肺功能指标[第1秒用力呼气容积（FEV1）、用力肺活量（FVC）]。结果：观察组肺部啰音、咳嗽、发热消失时间均短于对照组，差异均有统计学意义（P<0.05）。相较于治疗前，两组治疗7 d后的血清CRP、IL-6、TNF-α水平均降低，FEV1、FVC均升高，且观察组上述指标均优于对照组，差异均有统计学意义（P<0.05）。结论：支气管镜术可缩短儿童肺炎支原体肺炎伴气道内黏液栓患儿临床症状消失时间，降低炎症指标水平，提升患儿的肺功能。

【关键词】 肺炎支原体肺炎 气道内黏液栓 支气管镜术 炎症反应 肺功能

Application of Bronchoscopy in the Treatment of Mycoplasma Pneumoniae Pneumonia with Airway Mucus Embolus in Children/QIU Zaijun， LIN Ting， QIU Rongjun， WU Danxia， CHEN Jianqing. //Medical Innovation of China， 2021， 18（16）： 0-077

[Abstract] Objective： To analyze the application effect of bronchoscopy in the treatment of mycoplasma pneumoniae pneumonia with airway mucus embolus in children. Method： A total of 90 children with mycoplasma pneumoniae pneumonia complicated with airway mucus embolus treated in our hospital from January 2019 to October 2020 were selected as the research objects. They were divided into observation group and control group by lotting， with 45 cases in each group. The control group was treated with routine treatment， and the observation group was treated with bronchoscopy on the basis of the control group. The time of clinical symptom disappearance， inflammatory response indexes [interleukin-6 （IL-6）， C-reactive protein （CRP）， tumor necrosis factor α （TNF-α）]and lung function indexes （FEV1 and FVC） were compared between the two groups before treatment and after 7 d of treatment. Result： The disappearance time of pulmonary rales， cough， and fever in the observation group were shorter than those in the control group， the differences were statistically significant （P<0.05）. Compared with before treatment， serum levels of CRP， IL-6 and TNF-α in both groups after 7 d of treatment were decreased， while FEV1 and FVC were increased， and the above indexes in the observation group were better than those in the control group， with statistical significance （P<0.05）. Conclusion： Bronchoscopy can shorten the disappearance time of clinical symptoms in children with mycoplasma pneumoniae pneumonia and airway mucus embolus， reduce the level of inflammatory indicators， and improve the lung function of children.

[Key words] Mycoplasma pneumoniae pneumonia Airway mucus embolus Bronchoscopy Inflammatory reaction Lung function

First-author’s address： Shangrao People’s Hospital， Shangrao 334000， China

doi：10.3969/j.issn.1674-4985.2021.16.018

肺炎支原体肺炎多为肺炎支原体感染引起，易导致患儿出现气道内黏液栓，堵塞气道，引起闭塞性支气管炎、坏死性肺炎，造成肺炎吸收缓慢，进展为迁延性肺炎，严重影响患儿的日常生活。抗生素是既往临床治疗肺炎支原体肺炎伴气道内黏液栓患儿较为常用的治疗手段之一，可减轻患儿症状[1-2]。但由于抗生素在临床上的应用广泛，以致部分患儿采用抗生素治疗的效果不显著。……