支气管镜检查及肺泡灌洗术治疗儿童重症肺炎临床研究.docVIP

支气管镜检查及肺泡灌洗术治疗儿童重症肺炎临床研究 　　[摘要] 目的 探讨支气管镜检查及肺泡灌洗术在治疗儿童重症肺炎中的临床价值。 方法 将该院200例随机分成观察组和对照组各100例，对照组使用常规病原检测方法及常规治疗方法，观察组行支气管镜检查及肺泡灌洗术进行肺泡灌洗液收集及灌洗治疗，比较两组病原检出率、治疗效果和不良反应，以评价支气管镜检查及肺泡灌洗术在治疗重症肺炎中的临床价值。 结果 观察组肺泡灌洗液培养检测率65%，而对照组痰培养检测率52%；观察组支原体PCR阳性率42%，对照组肺炎支原体抗体阳性率31%，两者差异有统计学意义（P0.05）；观察组治疗总有效率99%（99/100），显著高于对照组治疗总有效率82%（82/100），两组临床疗效组间比较差异有统计学意义；两组患儿均未无严重不良反应发生。 结论 虽然支气管镜检查及肺泡灌洗术容易引起轻微的不良反应，但是相比于常规的痰培养或血清肺炎支原体抗体检测，肺泡灌洗液培养、肺泡灌洗液PCR检测率明显增高，且治疗效果明显提高，故根据患儿体质、病情等情况，值得推广使用。 　　[关键词] 支气管镜检查；肺泡灌洗；重症肺炎；病原检出率 　　[中图分类号] R59 [文献标识码] A [文章编号] 1674-0742（2015）05（b）-0030-02 　　Clinical Study of Bronchoscopy and Bronchoalveolar Lavage for Treatment of Severe Pneumonia in Children 　　HUANG Guang-ju，ZHANG Hui-yu，TIAN Ling，CHEN Na，WU Xiao-lei 　　CH Hospital of Tangshan City， Tangshang， Hebing Province， 063000 China 　　[Abstract] Objective To discuss the clinical value of fiberoptic bronchoscopy and bronchoalveolar lavage in treatment of severe pneumonia in children. Methods 200 cases were randomly divided into observation group and control group with 100 cases in each group. Conventional pathogen detection method and conventional treatment were performed in the control group， while bronchoscopy and bronchoalveolar lavage were used in the observation group for collection of bronchoalveolar lavage fluid and lavage treatment， additionally. Pathogen detection rate， curative effect and adverse reaction were compared between the two groups； the clinical value of fiberoptic bronchoscopy and bronchoalveolar lavage in the treatment of severe pneumonia was discussed. Results The detection rate of cultivation of bronchoalveolar lavage fluid and PCR positive rate of mycoplasma in the observation group were 65% and 52%，respectively，while cultivation detection rate of Sputum and mycoplasma pneumoniae antibodies positive rate in the control group were 42% and 31%，respectively， the differences were of statistically significant（P 　　[Key words] Bronchoscopy； Bronchoalveolar lavage； Severe pneumonia； P