目的 探讨膀胱镜在血尿患者膀胱病变诊断中的应用价值，并比较其与超声、CT尿路造影（CTU）、尿液细胞学的诊断效能差异，为临床精准诊疗提供参考。方法 回顾性选取在2020年6月至2025年6月期间本院收治的100例血尿患者作为研究对象，所有患者均 接受膀胱镜检查，以病理检查结果为金标准，分析病变类型分布情况；统计膀胱镜的诊断准确率、灵敏度、特异度；并比较4种检查方法对膀胱肿瘤的检出效能；记录并发症发生情况。结果 100例血尿患者经病理检查确诊：膀胱病变68例，其中膀胱肿瘤23例、膀胱炎26例、膀胱结石12例、膀胱息肉7例；非膀胱源性血尿32例。在膀胱肿瘤检出方面：超声灵敏度34.78%（8/23）、CTU灵敏度47.83%（11/23）、尿液细胞学灵敏度26.09%（6/23），而膀胱镜灵敏度为95.65%（22/23）。肉眼血尿组的膀胱病变检出率和膀胱肿瘤检出率均显著高于镜下血尿组（P<0.05）。经膀胱镜检查诊断：膀胱病变71例，阳性65例，阴性6例；非膀胱病变29例，阴性26例，阳性3例。膀胱镜的灵敏度、特异度和准确度分别为95.59%、81.25%、91.00%；膀胱镜与病理检查的一致性良好（kappa=0.894）。5例患者出现轻微血尿，3例患者出现尿道刺激症状，均在1～2天内自行缓解。无严重感染、膀胱穿孔等严重并发症发生。结论 膀胱镜检查对膀胱病变具有极高的诊断价值，其灵敏度显著优于超声、CTU及尿液细胞学。对于肉眼血尿患者，膀胱镜检查指征明确；对于镜下血尿患者，需结合危险因素综合评估检查必要性，避免过度医疗。

Objective This study explores the application value of cystoscopy in the diagnosis of bladder lesions in patients with hematuria, and compares its diagnostic efficacy with that of ultrasound, CT urography (CTU), and urine cytology, aiming to provide a reference for clinical precise diagnosis. Methods: A total of 100 patients with hematuria admitted to our hospital from June 2020 to June 2025 were retrospectively selected as the research subjects. All patients underwent cystoscopy. Taking the pathological examination results as the gold standard, the distribution of lesion types was analyzed, and the diagnostic accuracy, sensitivity, specificity of cystoscopy. Compare the detection efficacy of the four examination methods for bladder tumors; record the occurrence of complications. Results: Among 100 patients with hematuria, pathological examination confirmed that 68 cases had bladder lesions, including 23 cases of bladder tumors, 26 cases of cystitis, 12 cases of bladder stones, and 7 cases of bladder polyps. There were 32 cases of non-bladder origin hematuria. In terms of bladder tumor detection: the sensitivity of ultrasound was 34.78% (8/23), that of CTU was 47.83% (11/23), that of urine cytology was 26.09% (6/23), and that of cystoscopy was 95.65% (22/23). The detection rates of bladder lesions and bladder tumors in the group with gross hematuria were significantly higher than those in the group with microscopic hematuria (P < 0.05). Diagnosis by cystoscopy: 71 cases of bladder lesions, 65 positive cases and 6 negative cases. There were 29 cases of non-bladder lesions, including 26 negative cases and 3 positive cases. The sensitivity, specificity and accuracy of cystoscopy were 95.59%, 81.25% and 91.00% respectively. The consistency between cystoscopy and pathological examination was good (kappa=0.894). Five patients presented with mild hematuria and three patients had urethral irritation symptoms, all of which relieved spontaneously within 1 to 2 days. No serious complications such as severe infection or bladder perforation occurred. Conclusion: Cystoscopy has extremely high diagnostic value for bladder lesions, with its sensitivity significantly superior to ultrasound, CTU and urine cytology. For patients with gross hematuria, the indication for cystoscopy is clear; for those with microscopic hematuria, the necessity of the examination should be comprehensively evaluated based on risk factors to avoid excessive medical treatment.

摘要：目的：分析西双版纳傣族自治州地中海贫血髓外造血组织瘤样增生与胸部髓脂肪瘤的临床与CT影像学特征，筛选出可鉴别地中海贫血胸部髓外造血组织瘤样增生与胸部髓脂肪瘤的独立性影响因素。方法：选择2020年1月至2024年12月我院接诊的40例地中海贫血胸部髓外造血组织瘤样增生患者为病例组，选择同期就诊的40例胸部髓脂肪瘤患者为对照组进行回顾性分析。收集并比较两组患者一般资料及CT影像学特征，以多因素Logisitc回归筛选出独立性影响因素。结果：病例组与对照组性别、年龄、BMI、病灶最大径差异均无统计学意义（P>0.05），两组病灶部位、病灶数量、病灶形态、密度、强化情况差异均具有统计学意义（P<0.05）。多因素Logistic回归分析结果显示：病灶数量（OR=4.526，95%CI=1.258~16.281）、病灶形态（OR=0.310，95%CI=0.104~0.927）、密度（OR=6.704，95%CI=1.145~39.256）、强化情况（OR=4.062，95%CI=1.078~15.308）为地中海贫血髓外造血组织瘤样增生的鉴别两种疾病的独立性影响因素（P<0.05）。结论：病灶数量、病灶形态、密度等CT影像学特征可用于鉴别地中海贫血胸部髓外造血组织瘤样增生与胸部髓脂肪瘤。

       目的   研究小儿面颈部皮下良性肿物的影像学特点及经头皮区域或腋窝软组织腔镜微创治疗小儿头颈部皮下良性肿物的可行性、临床疗效及安全性。方法   回顾分析2024年1月—2024年8月在广州医科大学附属妇女儿童医疗中心治疗的24例小儿面颈部皮下肿物的病例，患儿年龄为1~5岁，平均年龄1.5岁，其中男15例、女9例；分别为甲状舌管囊肿10例，鳃裂瘘5例，前额皮下肿物5例，颈淋巴结增大3例，颈部皮下肿物1例。分析其影像学特点（超声及CT检查），制定了经头皮区域软组织腔镜微创治疗前额皮下肿物和颈淋巴结活组织检查（活检）或经腋窝软组织腔镜微创治疗甲状舌管囊肿和鳃裂瘘。结果  24例小儿面颈部皮下良性肿物的共同影像学特点是位于浅层，边界清晰，圆形或者椭圆形，对周围组织轻度压迫，无侵犯。所有病例均顺利完成微创手术，出血少，无手术并发症，术后恢复好。术后病理检查均提示良性肿物，面部及颈部均无手术瘢痕。结论   小儿面颈部皮下良性肿瘤的影像学特点是位于浅层，边界清晰。经头皮区域和腋窝软组织腔镜微创治疗小儿面颈部肿物效果确切、安全性高、美观。

       Objective  To  study the imaging characteristics of  subcutaneous  benign tumors in the face and  neck of children，as well as the feasibility，efficacy，and safety of minimally invasive treatment of subcutaneous benign tumors in the head and neck of children through hair area or axillary soft tissue endoscopy．Methods  A  retrospective analysis was conducted on 24 cases of subcutaneous tumors in the face and neck of children treated in our hospital from January to August 2024．Age  range was 1-5 years old，with an average of 1.5 years old．There were 15 boys and 9 girls．There were 10 cases of thyroglossal duct cyst，5 cases of branchial fistula，5 cases of subcutaneous mass on the forehead，3 cases of enlarged cervical lymph nodes，and 1 case of subcutaneous mass on the neck．Imaging characteristics（ultrasound and CT examination）and minimally invasive treatment effects were analyzed，to determine the procedure of minimally invasive treatment of subcutaneous tumors in the forehead and cervical lymph node biopsy by soft tissue endoscopy in the scalp area，and minimally invasive treatment of thyroglossal duct cysts and branchial fistulas through axillary by soft tissue endoscopy．Results  The imaging characteristics of subcutaneous benign tumors in children’s face and neck were located in the shallow layer，with clear boundaries，round or oval shapes，mild compression of surrounding tissues，and no invasion．All cases successfully underwent minimally invasive surgery with minimal bleeding，no  surgical complications，and good postoperative recovery．Postoperative pathological examination confirmed as benign masses．There were no surgical scars on the face and neck．Conclusions  The imaging characteristics of subcutaneous benign tumors in children’s face and neck are located in the shallow layer with clear boundaries．Minimally invasive endoscopic treatment of pediatric face and neck tumors through the scalp area and axillary soft tissue is effective，safe，and aesthetically pleasing．

目的 探讨CT、MRI影像学表现对原发性肝细胞癌（HCC）微血管侵犯（MVI）的诊断价值。方法 选取2018年1月—2024年7月江门市第二人民医院（江门市中心医院蓬江分院）和江门市中心医院120例（共158个病灶）HCC患者,均行上腹部CT、MRI平扫+增强及弥散加权成像（DWI）检查;以术后病理结果为金标准。比较CT、MRI平扫+增强及DWI对HCC MVI诊断效能;分析HCC MVI诊断中CT、MRI平扫+增强及DWI检查与术后病理确诊结果之间的一致性;比较HCC MVI与无HCC MVI患者影像学表现及表观扩散系数（ADC）值。结果 DWI检查对HCC MVI的诊断效能（灵敏度、特异度、准确度、阳性预测值、阴性预测值）均显著性高于CT、MRI平扫+增强（P<0.05）;CT、MRI、DWI对原发性肝细胞癌患者微血管侵犯的诊断效能比较,差异均无统计学意义（P>0.05）。在HCC MVI诊断效能中,CT、MRI影像学表现与术后病理确诊结果之间为中度一致性;DWI与术后病理确诊结果之间为高度一致性。HCC MVI患者的强化方式在非边缘动脉期强化、强化包膜、晕状强化、结中结、门脉分支癌栓占比均显著性高于无HCC MVI患者（P<0.05）。在不同b值（400、800、1 000、1 500 s/mm²）下,HCC MVI患者的ADC值均显著性高于无HCC MVI患者（P<0.05）。结论 CT、MRI平扫+增强及DWI对HCC MVI均具有较好的诊断效能,而MRI诊断结果与病理诊断一致性更佳,尤其DWI图中ADC值可更加精准地判断HCC的患者是否发生微血管侵犯,有助于指导临床医生建立“个体化”精准诊疗策略。

Objective To explore the diagnostic value of CT and MRI imaging manifestations for microvascular invasion（MVI）in primary hepatocellular carcinoma（HCC）．Methods A total of 120 patients（158 lesions in total）with HCC in the Second People’s Hospital of Jiangmen（Pengjiang Branch of Jiangmen Central Hospital）and Jiangmen Central Hospital were selected from January 2018 to July 2024,all underwent CT and MRI plain + enhanced and diffusion-weighted imaging（DWI）of the upper abdomen;postoperative pathology Results was used as the diagnostic gold standard．The diagnostic efficacy of CT,MRI plain + enhanced and DWI for HCC MVI was compared．The concordance among CT,MRI plain + enhanced and DWI examinations with postoperative pathological diagnostic findings in the diagnosis of HCC MVI．Imaging manifestations and apparent diffusion coefficient（ADC）values in patients with and without HCC MVI were compared．Results Diagnostic effectiveness of DWI examination for HCC MVI（sensitivity,specificity,accuracy,positive predictive value,negative predictive value）were all significantly higher than those of CT and MRI plain + enhanced（P<0.05）;none of the differences were statistically significant（P>0.05）in the comparison of diagnostic effectiveness of CT,MRI,and DWI for the diagnosis of MVI in patients with primary HCC．In HCC MVI diagnostic effectiveness,moderate concordance was found among CT,MRI imaging phenotypes and postoperative pathology Results;high concordance was found between DWI and postoperative pathology Results．In HCC MVI patients,the proportion of non-marginal arterial reinforcement,enhanced envelope,halo reinforcement,nodal in nodal and portal branch cancer thrombi was significantly higher than that in patients without HCC MVI（P<0.05）．At different b-values（400,800,1 000,1 500 s/mm²）,ADC values were all significantly higher in patients with HCC MVI than in patients without HCC MVI（P<0.05）．Conclusions CT,MRI plain + enhanced and DWI have good diagnostic effectiveness for HCC MVI,while MRI diagnostic Results are in better concordance with pathologic diagnosis．In particular,ADC values in DWI maps can more accurately determine whether MVI occurs in patients with HCC,which helps to guide clinicians to establish“individualized”and precise diagnosis and treatment strategies．

目的 研究煤工尘肺(coal worker's pneumoconiosis, CWP)患者电子计算机断层扫描(computed tomograghy, CT)的影像学表现。方法 选取2017年10月—2020年10月我院CWP患者102例,均行CT检查、X线胸片检查,比较CT检查、X线胸片检查影像学征象、小阴影形态、大阴影影像学表现,并对比CT检查、X线胸片检查并发症情况(灶周气肿、胸膜改变、淋巴结肿大、钙化)。结果 CT检查、X线胸片检查大阴影、肺内钙化影、肺大疱、空洞检出率比较,差异无统计学意义(P＞0.05);CT检查小阴影检出率82.03%高于X线胸片检查73.20%(P＜0.05);CWP患者小阴影主要形态为q/q,且CT检查q/q比例82.67%高于X线胸片检查72.77%(P＜0.05);CT检查灶周气肿31.37%、胸膜改变21.57%、淋巴结肿大15.69%、钙化18.63%, 高于X线胸片检查18.63%、10.78%、6.86%、8.82%(P＜0.05)。结论 CT检查CWP患者影像学征象、并发症检出率均高于X线胸片检查,且小阴影以q/q为主,对大阴影表现明显,有助于病情早期诊断及治疗方案的制定。

Objective To study the imaging features of computed tomograghy (CT) scanning in coal worker's pneumoconiosis (CWP). Methods A total of 102 CWP patients in our hospital from October 2017 to October 2020 were selected. CT examination and X-ray chest examination were performed to compare the imaging features, small shadow shape and large shadow imaging manifestations, and compared the complications of CT examination and X-ray chest examination (focal emphysema, pleura change, lymph node enlargement and calcification). Results There was no statistical difference in the detection rates of large shadow, calcification shadow, pulmonary bulla and cavity in CT and X-ray chest examination (P>0.05); the detection rate of small shadow in CT was 82.03%, which was higher than that of X-ray chest examination (73.20%, P<0.05); the main shape of small shadow in CWP patients was q/q, and the q/q ratio of CT examination was 82.67%, higher than that of X-ray chest examination (72.77%, P<0.05); the detection rates of the focal emphysema by CT examination was 31.37%, the changes of pleura were 21.57%, lymph node enlargement was 15.69%, calcification was 18.63%, which were higher than those of X-ray chest examination (18.63%, 10.78%, 6.86%, 8.82%, P<0.05). Conclusion The detection rate of imaging signs and complications in CWP patients by CT was higher than that of X-ray, and the small shadow was mainly q/q, and CT examination was obvious for detecting large shadow, which was helpful for the early diagnosis and treatment of the disease.

目的 分析2019新型冠状病毒(COVID-19)肺炎的肺部影像表现,提高对该病的影像学诊断认识。方法 回顾性分析2020年1月20日—2020年2月20日在我院就诊并最终经临床确诊的COVID-19肺炎患者的影像学及临床资料,所有患者均在入院后三天内行胸部X线检查或高分辨率CT平扫,分别记录每位患者两种影像检查方式的影像学表现,包括病灶累及的肺叶、磨玻璃影(GGO)、实变影、铺路石征、纤维索条及小叶间隔增厚等征象。结果 共22例确诊为COVID-19肺炎,其中男:女为1:1,年龄范围20~82岁;平均年龄为(52.9±16.2)岁。21例行胸部X线检查,其中有3例患者同时行肺部CT平扫检查;1例患者仅行胸部CT平扫检查。21例X线检查中16例(76%)胸片表现为斑片状、絮状致密影,余5例(24%)检查双肺未见异常征象。4例CT扫描患者中均可以见到病灶(100%),其中有3例(75%)累及5个肺叶,1例(25%)仅累及1个肺叶;均表现为胸膜下磨玻璃影、斑片状实变影、铺路石征、小叶间隔增厚、小血管增粗及支气管气象;其中1例(25%)出现淋巴结肿大;2例(50%)出现纤维索条影。结论 影像学检查对COVID-19的诊断和病情评估具有重要价值,其中X线检查对于部分病灶显示欠佳, 胸部CT平扫对于病变的检查较为准确,可作为COVID-19首选的影像学检查方法,为临床上早期诊断及治疗提供依据。

Objective To analyzed the pulmonary imaging manifestations of 2019 novel coronavirus (COVID-19) pneumonia, in order to improve the imaging diagnosis of the disease. Methods Retrospective analysis of the imaging and clinical data of 22 patients infected with the 2019 Novel Coronavirus (COVID-19) were reviewed, which all the patients took the X-ray or CT scan, and to record the images in the two types of inspection for each patient, including the involvement of the consolidation of the lung, ground-glass opacification, consolidation, paving stone chippings, fiber cable and interlobular septal thickening and so on. Results A total of 22 patients were diagnosed with COVID-19, and the ratio of male to female was 1:1, age range is 20~82, mean age is (52.9±16.2.21) patients received chest X-ray examination, including 3 patients received the non-contrast CT examination at the same time; 1 patient received chest CT plain examination only. 16 (76%) among the 21 patients with X-ray showed patchy and flocculent dense shadows, while the remaining 5 patients (24%) showed no abnormal signs in both lungs. 4 patients with CT scan can find the lesions. Among the 4 patients with detect CT scan, 3 patients (75%) involved 5 pulmonary lobes, and 1 patient (25%) only involved 1 pulmonary lobe. All of them showed subpleural ground-glass opacification, consolidation, paving stone chippings, fiber cable and interlobular septal thickening, including lymph node enlargement occurred in 1 case (25%), fiber strip shadows were observed in 2 cases (50%). Conclusion The imaging examination is of great value for the diagnosis and disease evaluation of COVID-19, among which X-ray examination is not good for some lesions, and CT plain scan is relatively accurate for the examination of lesions, which can be used as the preferred imaging method of COVID-19, providing further theoretical basis for early clinical diagnosis and treatment.

目的 分析毕节地区新型冠状病毒(2019-nCoV)肺炎(novel coronavirus pneumonia,NCP)胸部CT影像学表现,探讨对NCP的临床诊断的价值。方法 回顾性分析毕节市第三人民医院2020年1月14日至2月18日收治的13例NCP患者的流行病学特征及胸部CT影像学特征。结果 13例患者中2例为长期居住在武汉来毕;1例由从上海到湖北宜昌逗留3天返毕;1例直接与武汉当地人接触;3例为与确诊病人的密切接触者;5例是聚集性发病,均与从浙江省台州市返毕确诊病人密切接触;1例无流行病学史。胸部CT影像学以双肺或一侧肺散在斑片状、磨玻璃状高密度影,密度不均,边界不清,肺野外带显著为特征。重型患者短期内肺部CT影像学变化明显。结论 确诊NCP普通型患者胸部CT影像学大多以典型表现为特征;重型NCP患者短时间内可出现实变及肺纤维化。

Objective To analyze the novel coronavirus (2019-nCoV) novel coronavirus pneumonia (NCP) chest CT imaging findings in Bijie area, and to explore the clinical diagnostic value of NCP. Methods The epidemiological characteristics and chest CT features of 13 NCP patients admitted to The Third People's Hospital of Bijie from January 14 to February 18, 2020 were analyzed retrospectively. Results Among the 13 patients, 2 lived in Wuhan for a long time, 1 stayed for 3 days from Shanghai to Yichang, Hubei, and returned home; 1 directly contacted with the local people in Wuhan; 3 closely contacted with the confirmed patients; 5 were clustered diseases, all closely contacted with the confirmed patients returning from Taizhou, Zhejiang province; 1 had no epidemiological history. CT imaging of the chest is characterized by patchy, ground glass high-density shadows scattered in two or one side of the lung, with uneven density, unclear boundary and significant lung field zone. Conclusion Most of the chest CT images of the patients with NCP were characterized by typical manifestations, while consolidation and pulmonary fibrosis were found in the patients with severe NCP in a short period of time.

       目的   探讨CT、MRI影像学表现对原发性肝细胞癌（HCC）微血管侵犯（MVI）的诊断价值。方法   选取2018年1月—2024年7月江门市第二人民医院（江门市中心医院蓬江分院）和江门市中心医院120例（共158个病灶）HCC患者，均行上腹部CT、MRI平扫+增强及弥散加权成像（DWI）检查；以术后病理结果为金标准。比较CT、MRI平扫+增强及DWI对HCC MVI诊断效能；分析HCC MVI诊断中CT、MRI平扫+增强及DWI检查与术后病理确诊结果之间的一致性；比较HCC MVI与无HCC MVI患者影像学表现及表观扩散系数（ADC）值。结果    DWI检查对HCC MVI的诊断效能（灵敏度、特异度、准确度、阳性预测值、阴性预测值）均显著性高于CT、MRI平扫+增强（P＜0.05）；CT、MRI、DWI对原发性肝细胞癌患者微血管侵犯的诊断效能比较，差异均无统计学意义（P＞0.05）。在HCC MVI诊断效能中，CT、MRI影像学表现与术后病理确诊结果之间为中度一致性；DWI与术后病理确诊结果之间为高度一致性。HCC MVI患者的强化方式在非边缘动脉期强化、强化包膜、晕状强化、结中结、门脉分支癌栓占比均显著性高于无HCC MVI患者（P＜0.05）。在不同b值（400、800、1 000、1 500 s/mm² ）下，HCC MVI患者的ADC值均显著性高于无HCC MVI患者（P＜0.05）。结论    CT、MRI平扫+增强及DWI对HCC MVI均具有较好的诊断效能，而MRI诊断结果与病理诊断一致性更佳，尤其DWI图中ADC值可更加精准地判断HCC的患者是否发生微血管侵犯，有助于指导临床医生建立“个体化”精准诊疗策略。

       Objective  To explore the diagnostic value of CT and MRI imaging manifestations for microvascular invasion（MVI）in primary hepatocellular carcinoma（HCC）．Methods  A total of 120 patients（158 lesions in total）with HCC in the Second People’s Hospital of Jiangmen（Pengjiang Branch of Jiangmen Central Hospital）and Jiangmen Central Hospital were selected from January 2018 to July 2024，all underwent CT and MRI plain + enhanced and diffusion-weighted imaging（DWI）of the upper abdomen；postoperative pathology results was used as the diagnostic gold standard．The diagnostic efficacy of CT，MRI plain + enhanced and DWI for HCC MVI was compared．The concordance among CT，MRI plain + enhanced and DWI examinations with postoperative pathological diagnostic findings in the diagnosis of HCC MVI．Imaging manifestations and apparent diffusion coefficient（ADC）values in patients with and without HCC MVI were compared．Results  Diagnostic effectiveness of DWI examination for HCC MVI（sensitivity，specificity，accuracy，positive predictive value，negative predictive value）were all significantly higher than those of CT and MRI plain + enhanced（P＜0.05）；none of the differences were statistically significant（P＞0.05）in the comparison of diagnostic effectiveness of CT，MRI，and DWI for the diagnosis of MVI in patients with primary HCC．In HCC MVI diagnostic effectiveness，moderate concordance was found among CT，MRI imaging phenotypes and postoperative pathology results；high concordance was found between DWI and postoperative pathology results．In HCC MVI patients，the proportion of non-marginal arterial reinforcement，enhanced envelope，halo reinforcement，nodal in nodal and portal branch cancer thrombi was significantly higher than that in patients without HCC MVI（P＜0.05）．At different b-values（400，800，1 000，1 500 s/mm² ），ADC values were all significantly higher in patients with HCC MVI than in patients without HCC MVI（P＜0.05）．Conclusions  CT，MRI plain + enhanced and DWI have good diagnostic effectiveness for HCC MVI，while MRI diagnostic results are in better concordance with pathologic diagnosis．In particular，ADC values in DWI maps can more accurately determine whether MVI occurs in patients with HCC，which helps to guide clinicians to establish“individualized”and precise diagnosis and treatment strategies．

        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（χ ² =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。

     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（χ ² =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．