纤维支气管镜在小儿支原体肺炎伴肺不张诊断和治疗中临床价值.docVIP

纤维支气管镜在小儿支原体肺炎伴肺不张诊断和治疗中临床价值 　　[摘要] 目的 探讨纤维支气管镜治疗小儿支原体肺炎伴肺不张的临床疗效。 方法 回顾性分析2012年1月～2013年12月在本院治疗的93例小儿支原体肺炎伴肺不张的临床资料，分析纤维支气管镜治疗小儿支原体肺炎伴肺不张的临床疗效。 结果 93例肺不张患儿，16例为左上叶，17例为左下叶不张，6例为左上叶合并左下叶不张，19例为右上叶不张，27例为右中叶不张，5例为右下叶不张，2例为右上叶合并右中叶不张，1例为右中叶合并右下叶不张。灌洗液MP-DNA阳性率为87.1%，血清MP-Ab-IgM检测阳性率为64.5%，差异有统计学意义（P0.01）。纤维支气管镜检查2例患儿表现为支气管黏膜充血水肿严重，91例患儿除支气管黏膜充血水中外，还有其他症状，包括31例患儿痰栓堵塞支气管开口处而发生肺不张，30例患儿支气管黏膜形成纵行皱襞，22例患儿炎性狭窄，8例患儿发生溃疡性改变。治疗后4周，86.0%的患儿完全复张，11.8%的患儿部分复张，2.2%的患儿未复张。 结论 纤维支气管镜治疗小儿难治性肺不张具有较好的临床疗效，肺泡灌洗液MP-DNA的检出率显著高于血清MP-Ab-IgM的检出率。 　　[关键词] 纤维支气管镜；小儿支原体肺炎；肺不张 　　[中图分类号] R720.5 [文献标识码] A [文章编号] 1674-4721（2015）05（b）-0038-04 　　Clinical value of fiber bronchoscope in the diagnosis and treatment of pediatric Mycoplasma pneumonia accompanying with pulmonary atelectasis 　　LIU Yu-hui CHEN Wen-xia▲ DAI Yun-lei XIANG Heng-jie 　　Pediatric Intensive Care Unit，the First Affiliated Hospital of Henan University of Traditional Chinese Medicine，Zhengzhou 450000，China 　　[Abstract] Objective To explore the clinical effect of fiber bronchoscope in the treatment of pediatric Mycoplasma pneumonia accompanying with pulmonary atelectasis. Methods Clinical data from 93 pediatric Mycoplasma pneumonia cases with pulmonary atelectasis in our hospital from January 2012 to December 2013 were retrospectively analyzed in order to probe into the clinical effect on treating pediatric Mycoplasma pneumonia accompanying with pulmonary atelectasis by fiber bronchoscope. Results Among 93 cases with pulmonary atelectasis，there were upper left lobe in 16， left lower lobe in 17，upper left combined with left lower lobe in 6，upper right lobe in 19，right middle lobe in 27，lower right lobe in 5，upper right combined with right middle lobe in 2，and right middle lobe combined with lower right lobe in 1.The positive rate of MP-DNA lavage fluid was 87.1%，and positive rate of serum MP-Ab-IgM detection was 64.5%，with statistical differences（P 　　[Key words] Fiber bronchoscope；Pediatric Mycoplasma pneumonia；Pulmonary atelec