摘要
目的探讨纤维支气管镜在儿童难治性肺炎支原体肺炎(MPP)合并肺不张诊治中的应用。方法选取2013年10月—2014年10月湖南省儿童医院收治的MPP住院患儿43例为研究对象,均行纤维支气管镜检查和支气管肺泡灌洗治疗。观察纤维支气管镜下形态学表现特点,收集灌洗液进行细胞学分析和细菌培养。结果患儿纤维支气管镜下可见黏膜充血肿胀、分泌物附着,部分患儿伴有支气管通气不畅、叶或段支气管开口狭窄、支气管黏液栓形成、管腔炎性肿胀狭窄等。43例患儿肺泡灌洗液分析结果可见中性粒细胞计数升高35例(87.5%);细菌培养结果显示阳性9例(22.5%)。43例患儿共进行44例次灌洗治疗,显效29例;有效13例;首次灌洗治疗后无效,再次灌洗后症状缓解1例。对比患儿术前发热时间、住院时间,平均病程以及肺复张情况。结论行纤维支气管镜介入治疗儿童难治性肺炎支原体肺炎合并肺不张,有利于病变部位观察,控制感染,恢复肺通换气功能,是一种理想且相对安全的治疗方案。
Objective To explore the application of fiber bronchoscope in diagnosis and treatment of children mycoplasma pneumonia pneumonia（ MPP） complicated with pulmonary atelectasis. Methods Forty- three children with MPP admitted in Children ＇s Hospital of Hunan Province from Oct. 2013 to Oct. 2014 were selected and performed with fiber bronchoscopy and bronchoalveolar lavage. XX was observed under fiber bronchoscope and lavage fluid was collected for conducting cytological analysis and bacterial culture. Results Under fiber bronchoscope,mucosal hyperemia swelling and secretion attached were seen,and unsmooth bronchial ventilation,lobar and segment bronchial opening stenosis,mucous plugs,inflammatory swelling and stenosis in lumen occurred in partial children. Analysis results for bronchoalveolar lavage fluid showed that there were 35（ 87. 5%） of the increased neutrophil count,and bacterial culture result showed 9（ 22. 5%） positive. Of 43 children,44 were in excellent state and 13 in good state. 1 case who failed to lavage treatment initially relieved after lavage again. The fever time before operation,length of hospital stays,mean duation and recruitment maneuvers of children were compared. Conclusion Fiber bronchoscope performed for children mycoplasma pneumoniae pneumonia complicated with pulmonary atelectasis is an ideal and safe treatment method for it is conductive to the observation of diseased region,control of infection and recovery of pulmonary gas exchange function.
出处
《实用临床医药杂志》
CAS
2015年第23期78-81,共4页
Journal of Clinical Medicine in Practice
基金
中国高校医学期刊临床专项资金(11523286)
关键词
肺炎支原体肺炎
肺不张
支气管肺泡灌洗
纤维支气管镜
mycoplasma pneumoniae pneumonia
pulmonary atelectasis
bronchoalveolar lavage
fiber bronchoscope
