摘要
目的:探讨纤维支气管镜肺泡灌洗术联合阿奇霉素序贯治疗儿童支原体肺炎合并肺实变的效果。方法:筛选2022年2月至2024年3月南阳市第一人民医院收治的108例支原体肺炎合并肺实变患儿为研究对象,按照随机数字表法分为对照组和观察组,各54例。对照组患儿接受阿奇霉素序贯联合常规对症支持治疗,观察组患儿在对照组的基础上接受纤维支气管镜肺泡灌洗术治疗。比较两组患儿临床疗效、临床指标(发热、咳嗽、肺部啰音消失时间及住院时间),治疗前后实验室指标[免疫球蛋白(Ig)G、IgA、IgM、表面活性蛋白D(SP–D)、Toll样受体2(TLR2)、丙二醛(MDA)]及术后不良反应发生情况。结果:观察组患儿临床总有效率为92.59%,高于对照组的77.78%(P<0.05);观察组患儿发热、咳嗽、肺部啰音消失时间及住院时间均短于对照组(P<0.05);治疗后,观察组患儿血清SP–D、TLR2、MDA、IgG、IgM水平均低于对照组(P<0.05),两组患儿血清IgA水平比较,差异无统计学意义(P>0.05);两组患儿均未出现严重呼吸道损伤等不良反应,观察组术后仅出现2例短暂性咽喉不适,1例轻微鼻出血,均在对症处理后24 h内缓解。结论:纤维支气管镜肺泡灌洗术联合阿奇霉素序贯治疗儿童支原体肺炎合并肺实变,能显著提高临床疗效,缩短症状缓解和住院时间,改善相关实验室指标,且安全性较高。
Objective To explore the efficacy of bronchoscopic bronchoalveolar lavage combined with sequential azithromycin in the treatment of children with mycoplasma pneumonia complicated with pulmonary consolidation.Methods From February 2022to March 2024,108 children with mycoplasma pneumonia complicated with pulmonary consolidation admitted to Nanyang First People's Hospital were selected as the research subjects.They were randomly divided into a control group and an observation group,with 54 cases in each group.The control group received sequential azithromycin treatment combined with sequential conventional symptomatic supportive therapy,and the observation group received bronchoscopic bronchoalveolar lavage treatment in addition to the treatment of the control group.The clinical efficacy,clinical indicators(fever,cough,disappearance time of pulmonary rales and hospital stay),laboratory indicators[immunoglobulin(Ig)G,IgA,IgM,surfactant protein D(SPD),Toll-like receptor 2(TLR2),malondialdehyde(MDA)],and postoperative adverse reactions of the two groups were compared.Results The total clinical effective rate of the observation group was 92.59%,which was higher than that in the control group(77.78%,P<0.05);the disappearance time of fever,cough,pulmonary rales and hospital stay of the observation group were shorter than those in the control group(P<0.05);after treatment,the levels of serum SPD,TLR2,MDA,IgG,and IgM in the observation group were lower than those in the control group(P<0.05),and there was no statistically significant difference in the level of serum IgA between the two groups(P>0.05);neither group of children had serious respiratory tract injuries and other adverse reactions.The observation group only had 2 cases of transient throat discomfort and 1 case of mild nosebleed after surgery,which were relieved within 24 hours after symptomatic treatment.Conclusion Bronchoscopic bronchoalveolar lavage combined with sequential azithromycin in the treatment of children with mycoplasma pneumonia complicated with pulmonary consolidation can significantly improve clinical efficacy,shorten the duration of symptom relief and hospital stay,improve related laboratory indicators,and has a higher safety.
作者
于丹
徐瑞
姚川
YU Dan;XU Rui;YAO Chuan(Department of Pediatrics II,Nanyang First Peoples Hospital,Henan Nanyang 473000)
出处
《深圳中西医结合杂志》
2026年第3期93-96,共4页
Shenzhen Journal of Integrated Traditional Chinese and Western Medicine
关键词
支原体肺炎
肺实变
纤维支气管镜肺泡灌洗术
阿奇霉素
儿童
Mycoplasma pneumonia
Pulmonary consolidation
Bronchoscopic bronchoalveolar lavage
Azithromycin
Children
