CAJ | 학술논문

目的：探讨纤维支气管镜治疗小儿支原体肺炎伴肺不张的临床疗效。方法回顾性分析2012年1月~2013年12月在本院治疗的93例小儿支原体肺炎伴肺不张的临床资料,分析纤维支气管镜治疗小儿支原体肺炎伴肺不张的临床疗效。结果93例肺不张患儿,16例为左上叶,17例为左下叶不张,6例为左上叶合并左下叶不张,19例为右上叶不张,27例为右中叶不张,5例为右下叶不张,2例为右上叶合并右中叶不张,1例为右中叶合并右下叶不张。灌洗液MP-DNA阳性率为87.1%,血清MP-Ab-IgM检测阳性率为64.5%,差异有统计学意义(P<0.01)。纤维支气管镜检查2例患儿表现为支气管黏膜充血水肿严重,91例患儿除支气管黏膜充血水中外,还有其他症状,包括31例患儿痰栓堵塞支气管开口处而发生肺不张,30例患儿支气管黏膜形成纵行皱襞,22例患儿炎性狭窄,8例患儿发生溃疡性改变。治疗后4周,86.0%的患儿完全复张,11.8%的患儿部分复张,2.2%的患儿未复张。结论纤维支气管镜治疗小儿难治性肺不张具有较好的临床疗效,肺泡灌洗液MP-DNA的检出率显著高于血清MP-Ab-IgM的检出率。
목적：탐토섬유지기관경치료소인지원체폐염반폐불장적림상료효。방법회고성분석2012년1월~2013년12월재본원치료적93례소인지원체폐염반폐불장적림상자료,분석섬유지기관경치료소인지원체폐염반폐불장적림상료효。결과93례폐불장환인,16례위좌상협,17례위좌하협불장,6례위좌상협합병좌하협불장,19례위우상협불장,27례위우중협불장,5례위우하협불장,2례위우상협합병우중협불장,1례위우중협합병우하협불장。관세액MP-DNA양성솔위87.1%,혈청MP-Ab-IgM검측양성솔위64.5%,차이유통계학의의(P<0.01)。섬유지기관경검사2례환인표현위지기관점막충혈수종엄중,91례환인제지기관점막충혈수중외,환유기타증상,포괄31례환인담전도새지기관개구처이발생폐불장,30례환인지기관점막형성종행추벽,22례환인염성협착,8례환인발생궤양성개변。치료후4주,86.0%적환인완전복장,11.8%적환인부분복장,2.2%적환인미복장。결론섬유지기관경치료소인난치성폐불장구유교호적림상료효,폐포관세액MP-DNA적검출솔현저고우혈청MP-Ab-IgM적검출솔。
Objective To explore the clinical effect of fiber bronchoscope in the treatment of pediatric Mycoplasma pneumonia accompanying with pulmonary atelectasis. Methods Clinical data from 93 pediatric Mycoplasma pneumonia cases with pulmonary atelectasis in our hospital from January 2012 to December 2013 were retrospectively analyzed in order to probe into the clinical effect on treating pediatric Mycoplasma pneumonia accompanying with pulmonary at-electasis by fiber bronchoscope. Results Among 93 cases with pulmonary atelectasis,there were upper left lobe in 16, left lower lobe in 17,upper left combined with left lower lobe in 6,upper right lobe in 19,right middle lobe in 27,lower right lobe in 5,upper right combined with right middle lobe in 2,and right middle lobe combined with lower right lobe in 1.The positive rate of MP-DNA lavage fluid was 87.1%,and positive rate of serum MP-Ab-IgM detection was 64.5%,with statistical differences (P<0.01).By fibreoptic bronchoscopy,only two pediatric patients presented with severe congestion and edema of tunica mucosa bronchiorum.Besides that,among the rest 91 cases,other symptoms included pulmonary atelectasis due to sputum bolt blocking in the opening of bronchus(n=31),longitudinal plica in tunica mucosa bronchiorum (n=30),inflammatory stenosis (n=22),and ulcerative change (n=8).After 4 weeks treatment, percentages of complete reexpansion,partial reexpansion,and failed reexpansion was 86.0%,11.8%,and 2.2% respectively. Conclusion Fiber bronchoscope in the treatment of pediatric intractable pulmonary atelectasis obtains great clinical effect,and the detection rate of MP-DNA is remarkably higher than that of serum MP-Ab-IgM.