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《广州医药》编辑部
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.
患有发育障碍类疾病的儿童数量庞大,给社会造成了严重的影响。这类疾病难以预防和治愈,同时缺乏特效药物,因此治疗主要依赖于行为和教育干预,药物治疗只是辅助手段。然而,目前临床相关治疗均有一定的不足,如存在不良反应、治疗周期相对较长、专业性要求相对较高等缺点。与之相比,音乐疗法具有操作简便、不良反应少等优势,因此可应用于儿科多种慢性疾病的治疗。文章旨在通过研究现代音乐治疗,探讨结合古代五音疗法、现代知识以及中医理论,为儿童临床治疗提供一定的方法指导。
The number of children suffering from developmental disorders is substantial,causing significant impact on society.These diseases are difficult to prevent and cure,with a lack of specific medications,thus treatment primarily relies on behavioral and educational interventions,with medication being only an auxiliary measure.However,current clinical treatments have certain drawbacks,such as potential toxic side effects,relatively long treatment periods,and high demands for specialization.In contrast,music therapy offers significant advantages such as easy operation and minimal side effects,making it suitable for the treatment of various chronic pediatric disease.This paper aims to explore the integration of ancient pentatonic therapy,modern knowledge,and traditional Chinese medicine theory through the study of modern music therapy,providing guidance for clinical treatment of children.
目的 探讨眼底豹纹斑密度(FTD)及视盘旁萎缩弧(PPA)与眼轴长(AL)的相关性,为眼底定量化在儿童近视防控的应用提供科学依据。方法 本研究随机抽取广州市荔湾区两所小学三年级学生作为研究对象,在校园视力筛查的过程中同时采集AL、CR和眼底彩照。使用AI软件对眼底彩照进行量化分析,量化指标包括不同区域和范围的FTD及PPA面积大小,根据眼轴长度分为三组:A组(AL<23 mm);B组(23 mm≤AL<24 mm);C组(24 mm≤AL)。结果 共有398例右眼被纳入统计分析,年龄范围8~11岁,中位数是9岁,男性人数占55.1%。三组组间AL、AL/CR和SE比较均有统计学差异(P<0.05)。A组与B组相比,FTD在后极部整体范围、黄斑中心3 mm区域、黄斑中心3 mm区域上方区域具有统计学差异(P<0.05),C组与B组相比,PPA面积及FTD在后极部整体范围、视盘为中心4.5 mm范围、黄斑为中心直径3 mm和6 mm范围均具有统计学差异(P<0.05),Spearman相关性分析表明,AL与PPA(r=0.443)和FTD(r=0.322)呈正相关(P<0.001)。亚组相关性分析表明,A组仅黄斑为中心直径3 mm上方范围FTD与AL呈正相关(P=0.028),B组PPA、黄斑中心直径3 mm及其上方范围FTD与AL呈正相关(P<0.05),C组仅PPA与AL呈正相关(P=0.005)。结论 眼底定量对于儿童近视防控具有潜在价值,PPA和FTD与AL呈正相关性,不同区域和范围FTD与AL相关性具有一定差异性,黄斑中心直径3 mm范围及其上方范围与眼轴相关性最强。FTD在短眼轴阶段就可以作为生物标记物预测近视严重程度,而PPA主要在长眼轴阶段体现生物标记物的作用。
Objective To investigate the correlation between fundus tessellated density(FTD)and peripapillary atrophy(PPA)with axial length(AL), providing a scientific basis for the application of fundus quantification in the prevention and control of myopia in children. Methods This study randomly selected third-grade students from two primary schools in Liwan District, Guangzhou City, as research subjects. Axial length(AL), corneal radius(CR), and fundus color photographs were collected simultaneously during the school vision screening process. AI software was utilized to perform quantitative analysis on the fundus color photographs, with quantification indicators including the area size of PPA and FTD in different regions and ranges. Subjects were divided into three groups based on axial length:Group A(AL<23 mm); Group B(23 mm≤AL<24 mm); Group C(AL≥24 mm). Results A total of 398 right eyes were included in the statistical analysis, with an age range of 8 to 11, a median age of 9, and 55.1% were male. There were significant statistical differences in AL, AL/CR, and spherical equivalent(SE)among the three groups(P<0.05). Compared with Group B, Group A showed significant statistical differences in FTD in the overall posterior pole, the 3 mm diameter area centered on the fovea, and the superior area of the 3 mm foveal center(P<0.05). Compared with Group B, Group C showed significant differences in PPA area and FTD in the overall posterior pole, the 4.5 mm diameter area centered on the optic disc, and the 3 mm and 6 mm diameter areas centered on the fovea(P<0.05). Spearman correlation analysis indicated that AL was significantly positively correlated with PPA(r=0.443)and FTD(r=0.322)(P<0.001). Subgroup correlation analysis showed that in Group A, only the FTD in the superior area of the 3 mm diameter centered on the fovea was significantly positively correlated with AL(P=0.028). In Group B, PPA and FTD in the 3 mm diameter and superior area centered on the fovea were significantly positively correlated with AL(P<0.05). In Group C, only PPA was significantly positively correlated with AL(P=0.005). Conclusions Fundus quantification holds potential value for the prevention and control of myopia in children. PPA and FTD show significant positive correlations with AL, with varying degrees of correlation in different regions and ranges of FTD with AL. The 3 mm diameter area centered on the fovea and its superior area have the strongest correlation with the eye axis. FTD can serve as a biomarker to predict the severity of myopia in the early stages of eye axis elongation, while PPA primarily manifests as a biomarker in the later stages of elongation.