LUS在儿童重症肺炎纤维支气管镜肺泡灌洗治疗前后的应用价值OA

Objective:To explore the significance of lung ultrasound(LUS)assessments conducted both prior to and following fibreoptic bronchoscopic alveolar lavage(BAL)therapy in pediatric patients with severe pneumonia(SP),in order to assess whether it can be used as an effective means of monitoring the changes in the condition and the efficacy of treatment.Methods:Between January 2022 and December 2024,200 pediatric patients with SP at our hospital were recruited,the patients were divided into a control group(routine anti-infective treatment,n=100)and an experimental group(fiberoptic BAL treatment,n=100)using a single-blind method and a random number table.Both groups underwent LUS examinations pre-and post-treatment.Clinical symptom improvement,pulmonary function parameters[peak expiratory flow(PEF),forced expiratory volume in one second(FEV1),forced lung capacity(FVC)],extent of solid lung lesions,LUS score(total score for 12 regions out of 36,with higher scores representing more severe lesions),inflammatory markers[white blood cell counts(WBCs),C-reactive protein(CRPs),procalcitonin(PCT)],and correlations between LUS scores and inflammatory markers were recorded and analyzed.Results:In comparison to the control group,the experimental group exhibited a significant reduction in the time to recovery of body temperature[(9.67±1.65)h vs.(12.17±2.04)h],the time to disappearance of cough[(11.21±1.90)d vs.(14.26±2.27)d],the time to disappearance of rales[(10.89±1.73)d vs.(13.17±2.21)d]and the hospitalisation time[(12.97±3.49)d vs.(18.24±5.12)d]after BAL treatment(P<0.05),and the increase in PEF[(2.61±0.58)L vs.(2.02±0.59)L],FEV1[(64.08±2.77)%vs.(59.82±2.41)%],andFVC[(1.86±0.42)L vs.(1.72±0.44)L]was more pronounced in the experimental group(P<0.05).The LUS showed that the experimental group had a notably smaller area of solid pulmonary lesions compared to the control group[(10.43±3.06)cm2 vs.(15.29±4.69)cm2],accompanied by a significantly lower LUS score[(6.81±2.03)points vs.(8.11±2.18)points](P<0.05).In addition,the experimental group exhibited a more pronounced decrease in inflammatory markers,including WBC[(8.28±1.16)×109/L vs.(10.76±1.38)×109/L],CRP[(14.01±1.89)U/L vs.(20.73±2.56)U/L],PCT[(0.60±0.08)μg/L vs.(0.91±0.10)μg/L]levels(P<0.05).Additionally,there was a positive correlation between the LUS score and WBC、CRP、PCT(the control group:r=0.261,0.333,0.388,P<0.001;the experimental group:r=0.341,0.474,0.472,P<0.001).Conclusion:LUS quantitatively assesses SP lung lesions in children,and its score is highly correlated with the degree of inflammation,allowing effective monitoring of the effects of fibreoptic BAL therapy and providing a reliable basis for the assessment of radiation-free dynamics at the bedside.