支气管肺泡灌洗术治疗儿童感染性肺不张的疗效及安全性评价

【目的】 探讨支气管肺泡灌洗术(bronchoalveolar lavage,BAL)治疗儿童感染性肺不张的疗效及安全性。 【方法】 选取在本院住院确诊为感染性肺不张患儿80例,对照组40例为同时期根据痰培养和药敏结果选择抗菌素进行常规治疗,治疗组40例在纤维支气管镜下行支气管肺泡灌洗术联合常规治疗;4周后观察两组症状、肺部体征及肺部X线或CT变化,并观察并发症发生情况。 【结果】 治疗组疗效优于对照组,两组比较差异有统计学意义(P<0.01),4周后呼吸道症状、肺部体征治疗组明显较对照组好转消失快(P<0.01)及肺部X或CT吸收情况治疗组明显较对照组快(P<0.05)。治疗组并发症发生率:出血 2.5%,发热5%,喉头水肿2.5 %,支气管痉挛 2.5%,紫绀 2.5%。 【结论】 儿童感染性肺不张早期行支气管肺泡灌洗术可促使肺泡液排出,炎症吸收,使肺尽早复张,疗效确切,且安全性高,值得推广应用。

Effect and security of bronchoalveolar lavage on infected atelectasis in children

【Objective】 To explore the effect and security of bronchoalveolar lavage(BAL) on infected atelectasis in children. 【Methods】 The inpatients who diagnosed with infected atelectasis were retrospectively analyzed in our hospital,the control group(n=40) received only conventional therapy and antibiotic was based on Sputum culture and drug susceptibility,while the treatment group(n=40) received additional bronchoalveolar lavage via fibrobronchoscopy,both the treatment course were 4 weeks,then after 4 weeks the symptoms and signs,X ray or CT changes in the lung were observed,at the same time,the complications were also observed. 【Results】 The effect in the treatment group was better than in the control group,there was significantly difference between the two groups(P<0.01),The symptoms and signs recovered sooner in the treatment group than in the control group(P<0.01),X ray or CT changes in the lung recovered sooner in the treatment than in the control group(P<0.05)after 4 weeks.The incidences of complications in the treatment group were,hemorrhage 2.5%,fever 5%,laryngeal edema 2.5%,bronchospasm 2.5%,cyanosis 2.5%. 【Conclusions】 Bronchoalveolar lavage on infected atelectasis early can improve the transepithelial liquid to be transported,promote to absorbed the inflammation as early as possible and to reexpand the lung.The effect and security of BAL is definite and it deserves promotion.