CAJ | 학술논문

目的：肺炎支原体是儿童及青少年社区获得性肺炎的主要病原体之一，可引起肺炎支原体肺炎（ mycoplasma pneumoniae pneumonia ， MPP）。肺不张是MPP最常见的肺部表现之一。文中探讨纤维支气管镜术（ fiberoptic bronchoscopy ， FB）对小儿MPP合并肺不张的诊治作用。方法对2010年8月至2012年12月我科收治的99例小儿MPP合并肺不张患儿的临床资料及FB诊治结果进行回顾性分析。结果支气管肺泡灌洗液（ bronchoalveolar lavage fluid ， BALF） MP-DNA检测阳性92例（92．9％），血清MP-Ab-IgM阳性68例（68．7％）。 FB镜下均可见病变部位黏膜充血水肿，支气管开口处痰栓堵塞31例（31．3％），管腔炎性狭窄22例（22．2％），黏膜溃疡样改变7例（7．1％），小结节样改变3例（3．0％）。经过支气管肺泡灌洗（bronchoalveolar lavage ， BAL）治疗后4周仅3例未复张，部分和完全复张率达96．5％（82/85）。结论 BALF MP-DNA检测对MP感染的诊断优于血清MP-Ab-IgM检测，对于MPP合并肺不张患儿及早行FB介入治疗，缩短病程，促进肺复张。
목적：폐염지원체시인동급청소년사구획득성폐염적주요병원체지일，가인기폐염지원체폐염（ mycoplasma pneumoniae pneumonia ， MPP）。폐불장시MPP최상견적폐부표현지일。문중탐토섬유지기관경술（ fiberoptic bronchoscopy ， FB）대소인MPP합병폐불장적진치작용。방법대2010년8월지2012년12월아과수치적99례소인MPP합병폐불장환인적림상자료급FB진치결과진행회고성분석。결과지기관폐포관세액（ bronchoalveolar lavage fluid ， BALF） MP-DNA검측양성92례（92．9％），혈청MP-Ab-IgM양성68례（68．7％）。 FB경하균가견병변부위점막충혈수종，지기관개구처담전도새31례（31．3％），관강염성협착22례（22．2％），점막궤양양개변7례（7．1％），소결절양개변3례（3．0％）。경과지기관폐포관세（bronchoalveolar lavage ， BAL）치료후4주부3례미복장，부분화완전복장솔체96．5％（82/85）。결론 BALF MP-DNA검측대MP감염적진단우우혈청MP-Ab-IgM검측，대우MPP합병폐불장환인급조행FB개입치료，축단병정，촉진폐복장。
Objective Mycoplasma pneumoniae is one of the main pathogens of community-acquired pneumonia in children and teenagers , which may cause mycoplasma pneumoniae pneumonia ( MPP) .Atelectasis is one of the most common manifestations of MPP.The aim of the article was to evaluate the diagnostic and therapeutic value of fiberoptic bronchoscopy ( FB) in children with MPP associated with atelectasis . Methods Retrospective analysis were made on clinical data and FB records of 99 cases of hospitalized children with MPP associated with atelectasis from August 2010 to December 2012 . Results The positive rate of MP-DNA was 92.9%(92/99) in bronchoalveolar lavage fluid (BALF), and the positive rate of MP-Ab-IgM in serum was 68.7%(68/99).All pa-tients showed obviously bronchial mucosa congestive edema during FB examination .The results are as follows:bronchial phlegm bloc-king in 31 cases (31.3%), lumen inflammatory stenosis in 22 cases (22.2%),mucosal ulcer change in 7 cases(7.1%) and mucous nodular change in 3 cases (3.0%).4 weeks after being treated with bronchoalveolar lavage (BAL), only 3 cases remained in atelec-tasis, the partial and complete re-expansion rate reaching 96.5%(82 of 85). Conclusion The positive rate of BALF MP-DNA de-tection technology for the diagnosis of MP infection is higher than that of serum MP-Ab-IgM examination .Early interventional therapy by FB can shorten the course of disease and promote the lung re-expansion in children with MPP associated with atelectasis .