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《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:

期数:

2024年03期

页码:

397-401

栏目:

论著

出版日期:

2024-06-25

文章信息/Info

Title:

Application analysis of bronchoscopy in severe mycoplasma pneumoniae pneumonia of children

作者:

马甜甜¹; 张红军¹; 顾 兴¹; 李文洁¹; 赵延军¹; 苟超伦²; 严 雯²

710100 西安,西安市胸科医院呼吸与危重症医学科¹、妇儿结核科²

Author(s):

Ma Tiantian¹;  Zhang Hongjun¹;  Gu Xing¹;  Li Wenjie¹;  Zhao Yanjun¹;  Gao Chaolun²;  Yan Wen².

¹Department of Respiratory and Critical Care Medicine; ²Department of Gynecology and Pediatric Tuberculosis, Xi'an Chest Hospital, Xi'an 710100, China

关键词:

肺炎支原体肺炎;  支气管镜下治疗;  塑形性支气管炎

Keywords:

Bronchoscopic treatment;  Mycoplasma pneumoniae pneumonia;  Plastic bronchitis

分类号:

R563

DOI:

10.3877/cma.j.issn.1674-6902.2024.03.010

摘要:

目的 回顾性分析肺炎支原体肺炎(mycoplasma pneumoniae pneumonia, MPP)患儿临床资料,有助于支气管镜下治疗的重症肺炎支原体肺炎(severe mycoplasma pneumoniae pneumonia, SMPP)早期识别。方法 选择 2023年11月6日至 2023年12月14日我院呼吸与危重症医学科在支原体感染爆发期间收治的轻型和重型肺炎支原体肺炎158例,按照是否进行支气管镜下治疗,分为观察组84例支气管镜下治疗和对照组74例非支气管镜下治疗。比较两组患儿的性别、年龄、最高体温、白细胞、中性粒细胞、超敏C反应蛋白、胸部CT特征、病程、住院时间和住院费用等。结果 观察组年龄7～9岁53例(63.10%)高于对照组31例(41.89%)(P<0.05); 两组以重症为主,观察组60例(71.43%)高于对照组27例(36.49%)(P<0.001)。观察组最高体温(39.30±0.83)℃、和入院超敏C反应蛋白[18.51(8.10,42.71)]mg/L,从发病到开始住院时间A(8.96±5.56)d,住院时间B(8.54±2.90)d,总病程(A+B)(17.50±6.25)d,平均住院时间(9.08±2.92)d及住院费用(7 271.20±2 875.83)元高于对照组(38.84±0.80)℃、[10.03(3.70,21.72)]mg/L、(6.65±6.21)d、(6.70±2.01)d、(13.35±6.46)d、(7.53±2.10)d、(3 360.27±1 320.35)元(P<0.05)。胸部CT显示,两组治疗后两肺的感染面积较治疗前有明显的减少(P<0.005)。并发塑形性支气管炎(plastic bronchitis, PB)病例,经支气管镜下治疗后症状、病情及影像改善较好。结论 从年龄、体温、超敏C反应蛋白和病程等,结合胸部CT特征,早期识别SMPP患儿及需进行支气管镜下治疗,对提高SMPP患儿的救治具有临床意义。

Abstract:

Objective The clinical data of pediatric patients with mycoplasma pneumoniae pneumonia(MPP)admitted to the Department of Respiratory and Critical Care Medicine of our hospital were retrospectively analyzed, to explore the early identification of severe mycoplasma pneumoniae pneumonia(SMPP)requiring bronchoscopic treatment. Methods 158 cases of mild and severe MPP were recruited in our hospital from November 2023 to December 2023 during the outbreak of Mycoplasma infection, divided into the control group with non-bronchoscopic treatment 74 cases and the observation group with bronchoscopic treatment 84 cases. Then, the gender, age, highest body temperature, white blood cells, neutrophils, hypersensitive C-reactive protein, chest CT features, disease course, hospitalization time, and hospitalization costs of the two groups of patients were analyzed. Results In the observation group, the age of children was mainly 7-9 years old(63.10%), and the condition is mainly severe(71.43%), with a significant difference compared to the control group(P<0.05). The highest body temperature, admission hypersensitive C-reactive protein, length of hospital stay from onset to onset A, length of hospital stay B, total course of disease(A+B), average length of hospital stay, and hospitalization costs of the two groups were(38.84±0.80)℃ vs.(39.30±0.83)℃, [10.03(3.70,21.72)] mg/L vs. [18.51(8.10,42.71)]mg/L,(6.65±6.21 )days vs.(8.96±5.56)days,(6.70±2.01)days vs.(8.54±2.90)days,(13.35±6.46)days vs.(17.50±6.25)days,(7.53±2.10)days vs.(9.08±2.92)days,(3 360.27±1 320.35)yuan vs.(7 271.20±2 875.83)yuan, the observation group was higher than control group(P<0.05). Chest CT showed a significant reduction in the infection area of both lungs after treatment in both groups compared to before treatment, with statistical significance(P<0.005). A few cases of concurrent plastic bronchitis(PB)have shown good improvement in symptoms, condition, and imaging after bronchoscopic treatment. Conclusion Starting from general clinical data such as age, highest body temperature, hypersensitive C-reactive protein, and disease course, combined with chest CT features, early identification of SMPP patients who require bronchoscopic treatment can improve the treatment effectiveness of SMPP.

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备注/Memo

备注/Memo:

基金项目: 西安市科技计划项目(2022JH-YBYJ-0157)
通信作者: 张红军, Email: jxzhjun@126.com

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更新日期/Last Update: 2024-06-25