摘要
目的探讨支气管镜治疗在儿童肺炎支原体肺炎中的作用,并分析肺炎支原体肺炎伴黏液栓形成的危险因素。方法选择河北省儿童医院2017年5月至2019年3月收治的268例肺炎支原体肺炎患儿,按照随机数字表法将其分为对照组和观察组,各134例。对照组患儿给予常规药物治疗,观察组患儿在上述治疗的基础上加支气管镜治疗。比较2组患儿临床实验室指标变化,观察2组患儿治疗后肺部实变吸收面积变化。根据观察组患儿预后是否并发支气管黏液栓,将其分为黏液栓组(n=44)和非黏液栓组(n=90)2个亚组。对支气管镜治疗的肺炎支原体肺炎患儿并发支气管黏液栓危险因素进行分析,并通过绘制受试者工作特征曲线分析相关指标对其的预测价值。结果2组患者在住院时间、C反应蛋白恢复正常时间、白细胞恢复正常时间、热程以及肺部实变吸收面积方面差异具有统计学意义(P值均<0.05)。经多因素logistic回归分析显示,肺炎支原体肺炎患儿并发支气管黏液栓的危险因素是血栓素B2高、D-二聚体高、热程长、有胸腔积液以及年龄大(P值均<0.05)。对受试者工作特征曲线分析显示,血栓素B2和D-二聚体的曲线下面积分别是0.902、0.816。结论支气管镜治疗肺炎支原体肺炎疗效显著。肺炎支原体肺炎患儿并发黏液栓与其血栓素B2高、D-二聚体高、热程长、有胸腔积液以及年龄大关系密切,具有重要的临床应用意义。
Objective To explore the role of bronchoscopy in children with Mycoplasma pneumoniae pneumonia,and to analyze the risk factors of Mycoplasma pneumoniae pneumonia with mucus plug formation.Methods 268 children with Mycoplasma pneumoniae pneumonia admitted to Hebei Children′s Hospital from May 2017 to March 2019 were divided into control group and observation group,134 cases in each group.Patients in control group were given conventional drug treatment,while patients in observation group were treated with bronchoscopy on the basis of the above treatment.The changes in clinical laboratory indexes were compared between two groups,and the changes in the areas of pulmonary consolidation absorption after treatment in two groups were observed.According to the prognosis of patients in observation group,they were divided into two subgroups:mucus plug group(n=44)and non mucus plug group(n=90).The risk factors in Mycoplasma pneumoniae pneumonia complicated with bronchial mucus plugs in children treated by bronchoscopy were analyzed,and the predictive value of related indicators was obtained by drawing receiver operating characteristic(ROC).Results There were significant differences in hospital stay,C-reactive protein recovery time,white blood cell recovery time,heat course and pulmonary consolidation absorption area between two groups(all P<0.05).Multivariate logistic regression analysis showed that the risk factors of Mycoplasma pneumoniae pneumonia complicated with bronchial mucus plugs were high thromboxane B2,high D-dimer,long thermal course,pleural effusion and older age(all P<0.05).ROC curve showed that the areas under curve areas of thromboxane B2 and D-dimer were 0.902 and 0.816,respectively.Conclusions Bronchoscope has a significant effect on Mycoplasma pneumoniae pneumonia.In children with Mycoplasma pneumoniae pneumonia complicated with bronchial mucous plugs,high thromboxane B2,high D-dimer,long thermal course,pleural effusion and older age are closely related,which has important clinical significance.
作者
吴会芳
张景丽
刘晓娟
吴晓杰
张中平
段晨初
Wu Huifang;Zhang Jingli;Liu Xiaojuan;Wu Xiaojie;Zhang Zhongping;Duan Chenchu(Third Department of Respiratory Medicine,Hebei Children's Hospital,Shijiazhuang 050031,China)
出处
《国际呼吸杂志》
2021年第12期908-913,共6页
International Journal of Respiration
基金
河北省医学科学研究重点课题计划(20160426)。
关键词
支气管镜
肺炎支原体肺炎
儿童
支气管黏液栓
危险因素
Bronchoscopy
Mycoplasma pneumoniae pneumonia
Children
Bronchial mucus plug
Risk factors
