摘要
目的探讨儿童感染后闭塞性细支气管炎(PIBO)的高危因素,评价支气管镜肺泡灌洗联合激素雾化治疗儿童PIBO的疗效。方法选择肺部感染患儿5705例,其中PIBO患儿100例,采用单因素及Logistic回归分析PIBO的高危因素;将100例PIBO患儿随机分为灌洗组与雾化组,各50例。雾化组给予激素(普米克令舒)雾化治疗,灌洗组给予激素(普米克令舒)雾化+支气管镜肺泡灌洗治疗,比较2组临床疗效。结果单因素及Logistic回归分析显示,热程>12 d、肺部喘鸣音、呼吸困难、无创机械通气使用、合并腺病毒、喘息、呼吸衰竭是儿童PIBO的高危因素(P<0.05)。灌洗组气促、喘息、咳嗽、肺部啰音缓解时间短于雾化组(P<0.05)。治疗后,2组白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)低于治疗前(P<0.05),灌洗组低于雾化组(P<0.05);2组潮气量(TV)、达峰时间比(TPTEF/TE)、达峰容积比(VPEF/VE)高于治疗前(P<0.05),灌洗组高于雾化组(P<0.05);灌洗组治疗有效率(96.00%,48/50)高于雾化组(84.00%,42/50)(P<0.05)。结论肺部感染患儿PIBO与多种高危因素有关,支气管镜肺泡灌洗联合激素(普米克令舒)雾化治疗能改善PIBO患儿临床症状、炎症反应、肺潮气功能,可提高临床疗效。
Objective To explore the high risk factors of post-infectious bronchiolitis obliterans(PIBO)in children,and to evaluate the efficacy of bronchoscopic alveolar lavage combined with hormone nebulization in the treatment of PIBO in children.Methods 5705 children with pulmonary infection were selected,including 100 children with PIBO.Univariate and Logistic regression analysis were used to analyze the high risk factors of PIBO.A total of 100 children with PIBO were randomly divided into the lavage group and the nebulization group,with 50 cases in each group.The nebulization group received nebulization treatment with hormone(pulmicort),and the lavage group received nebulization treatment with hormone(pulmicort)and bronchoscopic alveolar lavage.The clinical efficacy of two groups was compared.Results Univariate and Logistic regression analysis showed that heat duration>12 days,pulmonary wheeze,dyspnea,use of non-invasive mechanical ventilation,concurrent adenovirus,wheezer and respiratory failure were the high risk factors for PIBO in children(P<0.05).The relief time of shortness of breath,wheezer,cough and pulmonary rales in the lavage group was shorter than that in the nebulization group(P<0.05).The levels of white blood cell(WBC),C-reactive protein(CRP)and procalcitonin(PCT)in two groups after treatment were lower than those before treatment(P<0.05),and the lavage group was lower than the nebulization group(P<0.05).The tidal volume(TV),time to peak tidal expiratory flow as a proportion of expiratory time(TPTEF/TE)and volume to peak expiratory flow as a proportion of exhsled volume(VPEF/VE)in two groups after treatment were higher than those before treatment(P<0.05),and the lavage group was higher than the nebulization group(P<0.05).The effective rate of the lavage group(96.00%,48/50)was higher than that of the nebulization group(84.00%,42/50)(P<0.05).Conclusion PIBO in children with pulmonary infection is associated with a variety of high risk factors.Bronchoscopic alveolar lavage combined with nebulization treatment with hormone(pulmicort)can improve clinical symptoms,imflammatory response,and lung tidal function of children with PIBO,and can enhance clinical efficacy.
作者
黄殷
肖力
廖卫彬
卫绮燕
韦僖雯
HUANG Yin;XIAO Li;LIAO Weibin;WEI Qiyan;WEI Xiwen(The Second Clinical Medical College of Southern Medical University,Guangzhou 510515,China;Foshan Maternal and Child Health Hospital,Foshan 528315,China)
出处
《长春中医药大学学报》
2024年第6期669-674,共6页
Journal of Changchun University of Chinese Medicine
基金
广东省省级科技计划项目(2019A020210002)。
关键词
儿童
感染后闭塞性细支气管炎
高危因素
支气管镜
肺泡灌洗
激素
children
post-infectious bronchiolitis obliterans
high risk factors
bronchoscopy
alveolar lavage
hormone
作者简介
黄殷(1984-),男,硕士研究生,主治医师,主要从事儿科呼吸专科及胸部介入检查与治疗研究;通信作者:肖力,男,硕士研究生导师,主任医师,电子信箱-Xiaoli71929@163.com。
