肺泡灌洗术治疗儿童大叶性肺炎的疗效观察

目的：观察纤维支气管镜肺泡灌洗术对儿童大叶性肺炎治疗的临床效果。方法收集第四军医大学附属唐都医院2015年1至12月121例儿童大叶性肺炎的临床资料，分析应用纤维支气管镜肺泡灌洗术在临床疗效上的差异。结果①病程≤7天的79例患儿，37例行纤维支气管镜肺泡灌洗术，1周后复查，治愈30例（占81．08％），42例对照组中治愈23例（占54．76％）；病程＞7天的42例患儿，22例行纤维支气管镜肺泡灌洗术，1周后复查，治愈17例（占77．27％），20例对照组中治愈11例（占55．00％）；②121例患儿静脉血中肺炎支原体（MP）阳性10例（8．26％），而59例行纤维支气管镜肺泡灌洗术患儿的肺泡灌洗液（BALF）中MP阳性者为47例（79．66％）；③病程在1周内的患儿接受纤维支气管镜肺泡灌洗术，其住院时间、热程均较对照组缩短（t值分别是2．394和2．101，均P＜0．05），肺部病变治愈率明显优于对照组（χ2＝6．171，P＜0．05）；而病程超过1周的患儿差异并无统计学意义。结论在大叶性肺炎患儿中，早期进行纤维支气管镜肺泡灌洗术治疗，可以有效缩短热程及住院天数，提高治愈率。检测BALF可提高MP的阳性检出率。

Clinical observation on the therapeutic effects of bronchoalveolar lavage in treating children with lobar pneumonia

Objective To observe the therapeutic effect of bronchoalveolar lavage by bronchofibroscope in treating children with lobar pneumonia .Methods Clinical data of 121 children with lobar pneumonia treated in Tangdu Hospital of the Fourth Military Medical University from January to December 2015 were collected . Differences in the therapeutic effect of bronchoalveolar lavage by bronchofibroscope were analyzed .Results Among 79 cases of patients whose course of disease were shorter or equal to 7 days, 37 cases underwent bronchoalveolar lavage by bronchofibroscope and had re-examination in one week . Among them, 30 cases were cured (81.08%).In addition, 23 out of 42 cases of patients in the control group were cured (54.76%).As for the other 42 cases of children whose course of disease were longer than 7 days, 22 of them received bronchoalveolar lavage by bronchofibroscope and re-examined in one week.Among them, 17 cases were cured (77.27%).Meanwhile, 11 out of 20 cases of patients in the control group were cured (55.00%).In total, 10 out of 121 cases (8.26%) of children showed positive result of mycoplasma pneumonia (MP) in their venous blood.In addition, 47 out of 59 (79.66%) cases of patients who underwent bronchoalveolar lavage by bronchofibroscope showed positive result of MP in bronchoalveolar lavage fluid (BALF).As for patients whose course of disease were shorter or equal to 7 days, they had shorter length of hospital stays and fever after receiving bronchoalveolar lavage by bronchofibroscope than patients in the control group ( t value was 2.394 and 2.101, respectively, both P<0.05).Besides, their recovery rate of pulmonary lesion was significantly superior to that of the control group (χ2 =6.171, P<0.05).But these differences were not statistically significant in patients whose course of disease were longer than 7 days.Conclusion Treating lobar pneumonia with bronchoalveolar lavage by bronchofibroscope at early stage can effectively shorten the duration of fever and hospital stays and eventually improve the recovery rate .Testing BALF can improve the positive detection rate of MP .