| 摘要: |
| 目的：观察小儿肺热咳喘口服液辅助纤维支气管镜肺泡灌洗术（BAL）治疗儿童难治性肺炎支原体肺炎（RMPP）合并肺部大片病灶的临床效果。方法：选取我院2011年2月至2015年3月收治的82例RMPP合并肺部大片病灶患儿作为研究对象，随机分为对照组和观察组各41例。两组均给予纤维支气管镜BAL治疗，观察组在此基础上加用小儿肺热咳喘口服液，比较两组治疗效果，观察患儿临床症状改善情况，测定两组患儿治疗前后血清白介素-6（IL-6）、白介素-4（IL-4）、γ干扰素（IFN-γ）水平的变化。结果：（1）观察组总有效率为92.7%，高于对照组的75.6%，差异有统计学意义（P<0.05）。（2）治疗后，两组各症状评分均降低，与治疗前比较差异有统计学意义（P<0.05），但观察组各症状评分降低幅度大于对照组（P<0.05）。（3）治疗后，两组各炎症指标水平均降低，与治疗前比较差异有统计学意义（P<0.05），但观察组降低幅度大于对照组（P<0.05）。（4）观察组患儿退热时间、肺部体征消失时间及住院时间均短于对照组（P<0.05）。结论：在常规抗感染的基础上，采用小儿肺热咳喘口服液辅助纤支镜BAL治疗RMPP合并肺部大片病灶患儿，可增加治疗总有效率，显著改善肺部症状及体征，下调血清炎症因子表达。 |
| 关键词: 难治性 肺炎支原体肺炎 肺部病灶 肺泡灌洗术 肺热咳喘口服液 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2016.12.008 |
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| 基金项目: |
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| Clinical Study on Xiaoer Feirekechuan Oral Drink Combined with Fiberoptic Bronchoscopic Bronchoalveolar Lavage in the Treatment of Children with Refractory Mycoplasma Pneumoniae Pneumonia Complicated with Large-area Lesions |
| Li Wenjin, Gao Jinyan, Hu Yinju |
| (Eryuan County People's Hospital of Yunnan Province, Yunnan Eryuan 671200, China) |
| Abstract: |
| Objective: To observe the clinical effect of Xiaoer Feirekechuan Oral Drink combined with fiberoptic bronchoscopic bronchoalveolar lavage (BAL) in the treatment of children with refractory mycoplasma pneumoniae pneumonia (RMPP) complicated with pulmonary large-area lesions. Methods: Eighty-two children with RMPP complicated with pulmonary large-area lesions treated in our hospital between February 2011 and March 2015 were randomized into control group and observation group, 41 cases in each group. Both groups were given fiberoptic bronchoscopic BAL. On the basis, the observation group was treated with Xiaoer Feirekechuan Oral Drink. The therapeutic effect was compared between the two groups, and the relief of clinical symptoms was observed. Changes of serum interleukin-6 (IL-6), interleukin-4 (IL-4) and interferon gamma (IFN- γ) in both groups before and after treatment were determined. Results: ① The total response rate in the observation group (92.7%) was higher than that in the control group (75.6%, P<0.05). ② After treatment, the symptom scores of both groups were reduced (P<0.05), and the scores of observation group were lower than those of control group (P<0.05). ③ After treatment, the inflammation indexes in both groups were decreased (P<0.05), and those in the observation group were lower than those in the control group (P<0.05). ④ The fever subsidence time, extinction time of pulmonary symptoms and hospitalization time of the observation group was shorter than that of the control group (P<0.05). Conclusion: The application of Xiaoer Feirekechuan Oral Drink combined with fiberoptic bronchoscopic BAL in intervention of children with RMPP complicated with pulmonary large-area lesions can clear away heat and toxic materials, ventilate the lung and eliminate phlegm, increase total response, significantly improve symptoms and pulmonary signs, and reduced expression of serum inflammatory factor. |
| Key words: refractory mycoplasma pneumoniae pneumonia pulmonary lesions bronchoalveolar lavage Feirekechuan Oral Drink |
