支气管肺泡灌洗术联合甲泼尼龙琥珀酸钠治疗儿童重症肺炎支原体肺炎的临床效果观察OA
Clinical Effect of Bronchoalveolar Lavage Combined with Methylprednisolone Sodium Succinate in the Treatment of Severe Mycoplasma pneumoniae Pneumonia in Children
目的 探讨支气管肺泡灌洗术联合甲泼尼龙琥珀酸钠治疗儿童重症肺炎支原体肺炎的疗效.方法 选取 2023年9月至2024年4月濮阳市人民医院儿科收治的103例重症肺炎支原体肺炎患儿,采用随机数字表法分为观察组(52例)和对照组(51例).所有入组患儿均符合重症肺炎支原体肺炎诊断标准,并具备可考虑行支气管镜介入治疗的临床条件,但均未达到必须立即实施支气管肺泡灌洗的抢救性指征.所有患儿均给予阿奇霉素等基础抗感染及对症治疗,对照组在此基础上给予甲泼尼龙琥珀酸钠,观察组进一步联合支气管肺泡灌洗术;对照组治疗过程中若出现持续气道阻塞、肺不张进展、呼吸衰竭加重等情况,则按临床救治原则及时实施支气管镜干预.比较两组临床疗效、体温恢复正常时间、啰音消失时间、咳嗽好转时间、肺部病灶吸收情况及临床不良事件发生情况.结果 观察组治疗有效率和肺部病灶吸收率均高于对照组;体温恢复正常时间、啰音消失时间、咳嗽好转时间均短于对照组,差异均有统计学意义(P＜0.05).两组疾病相关并发症发生率比较,差异无统计学意义(P＞0.05).结论 支气管肺泡灌洗术联合甲泼尼龙琥珀酸钠治疗儿童重症肺炎支原体肺炎可改善短期临床症状、促进病灶吸收,且短期内未见并发症发生率明显升高,但其长期安全性仍需进一步研究.
Objective To investigate the efficacy of bronchoalveolar lavage combined with methylprednisolone sodium succinate in the treatment of severe Mycoplasma pneumoniae pneumonia in children.Methods A total of 103 children with severe Mycoplasma pneumoniae pneumonia admitted to the Department of Pediatrics of Puyang People's Hospital from September 2023 to April 2024 were selected and divided into an observation group(52 cases)and a control group(51 cases)using a random number table method.All enrolled children met the diagnostic criteria for severe Mycoplasma pneumoniae pneumonia and had clinical conditions under which bronchoscopic intervention could be considered;however,none had emergency indications requiring immediate bronchoalveolar lavage.All children received basic anti-infective treatment,including azithromycin,and symptomatic treatment.On this basis,the control group received methylprednisolone sodium succinate,while the observation group additionally received bronchoalveolar lavage.If children in the control group developed persistent airway obstruction,progression of atelectasis,worsening respiratory distress,or other conditions requiring bronchoscopic rescue,bronchoscopic intervention was performed according to clinical needs.The clinical efficacy,time to normalization of body temperature,time to disappearance of rales,time to improvement of cough,absorption of pulmonary lesions,and incidence of clinical adverse events were compared between the two groups.Results The overall response rate and pulmonary lesion absorption rate in the observation group were higher than those in the control group.The time to normalization of body temperature,time to disappearance of rales,and time to improvement of cough in the observation group were shorter than those in the control group,and all differences were statistically significant(P＜0.05).There was no statistically significant difference in the incidence of disease-related complications between the two groups(P＞0.05).Conclusion Bronchoalveolar lavage combined with methylprednisolone sodium succinate can improve short-term clinical symptoms and promote lesion absorption in children with severe Mycoplasma pneumoniae pneumonia,without a significant short-term increase in the incidence of complications.However,its long-term safety requires further investigation.
郭晓冉;张敬芳;胡湘萍;王玮;柴焕然
濮阳市人民医院 儿科二病区,河南 濮阳 457000濮阳市人民医院 儿科二病区,河南 濮阳 457000濮阳市人民医院 儿科二病区,河南 濮阳 457000濮阳市人民医院 儿科二病区,河南 濮阳 457000濮阳市人民医院 儿科二病区,河南 濮阳 457000
重症肺炎支原体肺炎儿童支气管肺泡灌洗术甲泼尼龙琥珀酸钠临床疗效
severe Mycoplasma pneumoniae pneumoniachildrenbronchoalveolar lavagemethylprednisolone sodium succinateclinical efficacy
《临床研究》 2026 (6)
29-32,4
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