难治性肺炎支原体肺炎支气管镜下灌洗次数的影响因素分析

目的:探讨难治性肺炎支原体肺炎(RMPP)支气管镜下灌洗次数的影响因素。方法:回顾性分析2016年1月30日至2019年5月30日于我院接受支气管镜下灌洗的125例RMPP患儿的临床资料,根据支气管镜下灌洗次数将患儿分为单次灌洗组(85例)和多次灌洗组(40例),记录两组患儿糖皮质激素使用情况,比较两组患儿临床表现及生化资料,分析RMPP多次灌洗的影响因素。结果:多次灌洗组患儿使用糖皮质激素比例低于单次灌洗组,差异有统计学意义(P<0. 05)。多次灌洗组患儿热程≥7 d、病程≥7 d、存在胸腔积液、支气管阻塞、黏膜糜烂比例及C反应蛋白(CRP)、乳酸脱氢酶(LDH)、中性粒细胞比值(N)水平均高于单次灌洗组,差异有统计学意义(P<0. 05)。多因素Logistic回归分析显示,灌洗前1周使用糖皮质激素是灌洗次数的保护因素,而热程≥7 d、CRP≥44 mg/L、LDH≥480 U/L、黏膜糜烂、支气管阻塞是灌洗次数的危险因素(P<0. 05)。结论:RMPP支气管镜下灌洗次数的影响因素较多,早期使用糖皮质激素是RMPP支气管镜下灌洗次数的保护因素,可减少支气管镜下灌洗次数。

Influencing Factors of Times of Bronchoscopic Lavage Therapy in Refractory Mycoplasma Pneumoniae Pneumonia

Objective: To investigate the influencing factors of times of bronchoscopic lavage therapy in refractory Mycoplasma Pneumoniae pneumonia( RMPP). Methods: Retrospective analysis was conducted on clinical data of 125 children with RMPP undergoing bronchoscopic lavage in our hospital from Jan. 30th,2016 to May 30th,2019. All children were divided into the single lavage group( n=85)and the multiple lavage group( n = 40) according to the times of bronchoscopic lavage therapy. Application of glucocorticoids in two groups were recorded. The clinical manifestations and biochemical data were compared,and the influencing factors of multiple bronchoscopic lavage therapy in RMPP were analyzed. Results: The proportion of application of glucocorticoids in the multiple lavage group was lower than that in the single lavage group,and the difference was statistically significant( P<0. 05). The heat duration ≥7 d,disease course ≥7 d,pleural effusion,bronchial obstruction,mucosal erosion,C-reactive protein( CRP),lactate dehydrogenase( LDH) and neutrophil ratio( N) in the multiple lavage group were higher than those in the single lavage group,the difference was statistically significant( P<0. 05). Multivariate Logistic regression analysis showed that the application of glucocorticoids at one week before lavage was the protective factor for the times of bronchoscopic lavage therapy,while the heat duration ≥7 d,CRP≥44 mg/L,LDH≥480 U/L,mucosal erosion and bronchial obstruction were risk factors for the times of bronchoscopic lavage therapy( P<0. 05). Conclusion: There are many influencing factors for multiple bronchoscopic lavage therapy in RMPP. Early application of glucocorticoids is the protective factors for the times of bronchoscopic lavage therapy in RMPP,which can reduce the times of bronchoscopic lavage therapy.