CAJ | 학술논문

目的探讨儿童肺炎支原体肺炎(MPP)合并肺不张的临床特点及纤维支气管镜(纤支镜)和肺泡灌洗的诊治效果及介入时机.方法选取2012年6月至2013年3月住院的MPP合并肺不张行纤支镜和肺泡灌洗检查的患儿53例为试验组,选取同期住院MPP未合并肺不张患儿35例为对照组,根据平均介入时间将试验组患儿分为早期组和晚期组,总结分析临床、实验室及支气管镜检查特点.结果试验组患儿平均发热时间、住院时间及血清C-反应蛋白(CRP)均高于对照组(P＜0.05).试验组患儿肺不张部位多集中在右肺中叶(18例,33.9％),支气管镜下均可见黏膜充血肿胀及分泌物附着,部分可见黏膜滤泡样增生(9例,17.0％)、黏膜糜烂(3例,5.7％)、黏液栓形成(7例,13.2％)、段支气管通气不良(4例,7.5％),其肺泡灌洗液可见中性粒细胞升高(43例,81.1％)、吞噬细胞减少(31例,58.5％).经过治疗,l例(1.8％)经纤支镜治疗1次无效自动出院,52例(98.1％)患儿经治疗后均复张;支气管镜介入早期组热退时问、平均住院时问均短于晚期组(P＜0.05).结论 MPP合并肺不张患儿平均发热时问长,CRP升高明显,支气管镜介入治疗能够促进肺不张的恢复,早期行纤支镜介入治疗能有效缩短发热时间及住院时间.
목적 탐토인동폐염지원체폐염(MPP)합병폐불장적림상특점급섬유지기관경(섬지경)화폐포관세적진치효과급개입시궤.방법 선취2012년6월지2013년3월주원적MPP합병폐불장행섬지경화폐포관세검사적환인53례위시험조,선취동기주원MPP미합병폐불장환인35례위대조조,근거평균개입시간장시험조환인분위조기조화만기조,총결분석림상、실험실급지기관경검사특점.결과 시험조환인평균발열시간、주원시간급혈청C-반응단백(CRP)균고우대조조(P＜0.05).시험조환인폐불장부위다집중재우폐중협(18례,33.9％),지기관경하균가견점막충혈종창급분비물부착,부분가견점막려포양증생(9례,17.0％)、점막미란(3례,5.7％)、점액전형성(7례,13.2％)、단지기관통기불량(4례,7.5％),기폐포관세액가견중성립세포승고(43례,81.1％)、탄서세포감소(31례,58.5％).경과치료,l례(1.8％)경섬지경치료1차무효자동출원,52례(98.1％)환인경치료후균복장;지기관경개입조기조열퇴시문、평균주원시문균단우만기조(P＜0.05).결론 MPP합병폐불장환인평균발열시문장,CRP승고명현,지기관경개입치료능구촉진폐불장적회복,조기행섬지경개입치료능유효축단발열시간급주원시간.
Objective To explore the clinical characteristics of mycoplasma pneumonia with pulmonary atelectasis and lavage interventional effect through fiberoptic bronchoscopy in children.Methods During Jun 2012 to Apr 2013,fifty-three children diagnosed of mycoplasma pneumonia with pulmonary atelectasis who received fiberoptic bronchoscopy were enrolled as the experimental group.Thirty-five children diagnosed of mycoplasma pneumonia without pulmonary atelectasis were chosen as control group.According to the lavage interventional time of fiberoptic bronchoscopy,we divided the patients in the experimental group into two groups,the early group and late group.Clinical data and laboratory finds were collected and analyzed.Results The duration of fever,hospital stay and C-reactive protein (CRP) of the experimental group were significantly higher than those of the control group (P ＜ 0.05).The location of pulmonary atelectasis in the experimental group were usually in the right middle lobe (18 cases,33.9％).Under fiberoptic bronchoscope,all patients had obviously bronchial mucosa congestive edema.Some of them had follicular hyperplasia (9 cases,17.0％),mucosal erosion (3 cases,5.7％),mucus plug formation (7 cases,13.2％) and poor ventilation of segmental bronchi (4 cases,7.5 ％).Neutrophils (43 cases,81.1％) increased and phagocytic cells (31 cases,58.5％) dereased obviously in bronchoalevolar lavage fluid.After treatment in the experimental group,52 children (98.1％) got complete recruitment of atelectasis.The average duration of fever and hospital stay of the early group were significantly shoter than those of late group (P ＜ 0.05).Conclusion Children diagnosed of mycoplasma pneumonia with pulmonary atelectasis had longer fever duration and higher CRP level.Bronchoscopic interventional therapy promoted the recovery of pulmonary atelectasis.Using bronchoscop early in shorten the duration of fever and hospitalization in children diagnosed of mycoplasm pneumonia with pulmonary atelectasis.