支气管镜联合雾化吸入药物对肺炎支原体肺炎患儿症状持续时间及肺部影像学好转情况分析

doi:10.20223/j.cnki.1000-8535.2025.03.014

摘要/Abstract

摘要： 目的探究支气管镜联合雾化吸入药物对肺炎支原体肺炎患儿症状持续时间及肺部影像学好转情况。方法选取94例肺炎支原体肺炎患儿为研究对象,以随机数字表法分为A组、B组,各47例,分别实施布地奈德雾化吸入治疗、支气管镜肺泡灌洗联合布地奈德雾化吸入治疗,比较两组症状持续时间、治疗后肺部影像改善情况、炎症指标水平及不良反应发生率。结果 B组体温恢复时间（2.73±0.51）d、咳嗽消失时间（5.98±1.24）d、住院时间（10.96±3.36）d,A组分别为（3.14±0.83）（7.06±2.33）（13.27±3.18）d,B组较A组短（t=2.885、2.809、3.423,均P<0.05）;治疗后B组40.43%阴影完全消失、34.04%阴影显著缩小、23.40%阴影有所缩小、2.13%阴影改善不明显,A组分别为21.28%、36.17%、25.53%、17.02%,B组肺部阴影改善情况优于A组（Z=8.311,P<0.05）;治疗前B组白细胞计数（WBC）、超敏C-反应蛋白（hs-CRP）、降钙素原（PCT）水平与A组相近（P>0.05）;治疗后B组WBC（7.71±1.94）×10⁹/L、hs-CRP（4.96±1.44）mg/L、PCT（84.32±21.40）pg/mL,A组分别为（9.05±2.48）×10⁹/L、（6.17±1.85）mg/L、（105.46±34.02）pg/mL,B组水平较A组低（t=2.918、3.538、3.606,均P<0.05）;B组不良反应发生率为8.52%,A组为4.26%,B与A组相近（χ²=0.178,P>0.05）。结论对肺炎支原体肺炎患儿实施支气管镜联合雾化吸入药物治疗,可缩短康复时间,促进肺部阴影消退,降低其炎症指标水平,且未增加不良反应发生率。

关键词: 肺炎支原体肺炎, 支气管镜, 雾化吸入治疗

Abstract: Objective To investigate the effect of bronchoscopy combined with nebulized inhalation of medication on the duration of symptoms and pulmonary imaging conversion in children with Mycoplasma pneumoniae pneumonia（MPP）．Methods A total of 94 children with MPP were selected as the research subjects and randomly divided into Group A and Group B using a random number table,with 47 cases in each group．They were treated with budesonide nebulization inhalation therapy and bronchoalveolar lavage combined with budesonide nebulization inhalation therapy,respectively．The duration of symptoms,improvement of lung imaging before and after treatment,levels of inflammatory indicators,and incidence of adverse reactions were compared between the two groups．The results showed that the temperature recovery time was（2.73±0.51）days,cough disappearance time was（5.98±1.24）days,and hospitalization time was（10.96±3.36）days in Group B,（3.14±0.83）days,（7.06±2.33）days,and（13.27±3.18）days in Group A,respectively．Durpation in Group B was shorter than Group A（t=2.885,2.809,3.423,all P<0.05）．After treatment,40.43% of the shadows in Group B completely disappeared,34.04% of the shadows significantly reduced,23.40% of the shadows reduced,and 2.13% of the shadows showed no significant improvement,better than 21.28%,36.17%,25.53%,and 17.02% in Group A（Z=8.311,P<0.05）．Before treatment,the white blood cell count（WBC）,high-sensitivity C-reactive protein（hs CRP）,and procalcitonin（PCT）levels in group B were similar to those in Group A（P>0.05）．After treatment,the WBC（7.71±1.94）×10⁹/L,hs CRP（4.96±1.44）mg/L,and PCT（84.32±21.40）pg/mL in Group B were lower than those in Group A（9.05±2.48）×10⁹/L,（6.17±1.85）mg/L,and（105.46±34.02）pg/mL,respectively（t=2.918,3.538,3.606,all P<0.05）．The incidence of adverse reactions in Group B was 8.52%,while in Group A it was 4.26%．The incidence of adverse reactions in group B was similar to that in group A（χ²=0.178,P>0.05）．Conclusions Bronchoscopy combined with nebulized inhalation therapy for children with MPP can shorten the recovery time,promote the disappearance of lung shadows,reduce their inflammatory index levels,and without increasing the incidence of adverse reactions．

Key words: mycoplasma pneumoniae pneumonia, bronchoscopy, nebulization inhalation therapy

李兰英, 彭慧云, 江杰, 曾津, 胡宇敏, 方珊珊. 支气管镜联合雾化吸入药物对肺炎支原体肺炎患儿症状持续时间及肺部影像学好转情况分析[J]. 广州医药, 2025, 56(3): 377-381.

LI Lanying, PENG Huiyun, JIANG Jie, ZENG Jin, HU Yumin, FANG Shanshan. Analysis of the duration of symptoms and pulmonary imaging conversion in children with Mycoplasma pneumoniae pneumonia treated with bronchoscopy combined with nebulized inhalation of medication[J]. Guangzhou Medical Journal, 2025, 56(3): 377-381.

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