摘要
目的探讨儿童难治性肺炎支原体肺炎(RMPP)纤维支气管镜镜下常见形态学改变,灌洗液细胞学成分特点,观察支气管肺泡灌洗治疗效果。方法回顾性总结28例RMPP镜下常见形态学改变及灌洗液细胞学成分特点;比较支气管肺泡灌洗与未灌洗者临床疗效及转归。结果 28例RMPP患儿镜下均见病变部位支气管黏膜肿胀充血,可见多少不等的粘性分泌物。灌洗液细胞学成分分析结果显示,与对照组相比,RMPP患儿细胞总数上升(P<0.05),其中以中性粒细胞上升为主(P<0.05)。行灌洗RMPP患儿痊愈率(81.07%)显著高于未灌洗组(44.40%);行灌洗RMPP患儿肺部啰音出现及消失早;影像学改变恢复好,且较未灌洗组恢复快(P<0.05)。结论 RMPP患儿纤维支气管镜镜下形态学特点以及支气管肺泡灌洗液细胞学成分分析对诊断RMPP有一定帮助;纤维支气管镜灌洗对RMPP有治疗作用。
【Objective】To explore early clinical diagnosis of refractory mycoplasma pneumoniae pneumonia （RMPP） through summarizing the features of morphologic features under bronchoscope and differential cell count in bronchoalveolar lavage fluid, and to evaluate the effect of bronchoalveolar lavage （BAL） in the treatment of RMPP. 【Methods】The common morphologic features of 28 patients of RMPP who were given flexible fiberoptic bronchoscopy and differential cell count in bronchoalveolar lavage fluid were analyzed. And the differences in clinic effect and turnover between the RMPP patients with and without bronchoalveolar lavage were compared.【Results】 Under flexible bronchoscope, it was obvious that bronchial mucosa swelling and glutinosity secretions were shown in all patients. Compared with the control group, the total cells in BALF from children with RMPP was significantly increased （P 0.05）, and the percentage of neutrophil was significantly increased （P 0.05）. The clinical cure rates （81.07%） in RMPP group BAL was significant higher than those of non-BAL group （44.40%）. In group BAL, the time of appearance and disappearance of clinical lung signs were significantly earlier than those of group non-BAL and the imagery of radiography improved faster than that of group non-BAL. 【Conclusion】The morphologic features under fiberoptic bronchoscopy and the differential cell counts in BALF of RMPP patients are helpful for diaognosis of RMPP. The operation of Bronchoalveolar lavages by flexible bronchoscope is beneficial to treat patients with RMPP.
出处
《中国内镜杂志》
CSCD
北大核心
2010年第10期1042-1045,共4页
China Journal of Endoscopy
关键词
难治性肺炎支原体肺炎
纤维支气管镜
支气管肺泡灌洗
儿童
refractory mycoplasma pneumoniae pneumonia （RMPP）
fiberoptic bronchoscopy （FB）
bronchoalveolar lavage （BAL）
children
