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肺泡灌洗术联合乙酰半胱氨酸肺泡灌洗治疗小儿肺不张的临床效果
黎德郡1,陈峋2,覃丽燕1,周涛1,周艳2,曾俞榕1
0
(1.广西梧州市工人医院,广西梧州 543001;2.广西医科大学第一附属医院,广西南宁 530021)
摘要:
目的:观察支气管镜肺泡灌洗术联合吸入用乙酰半胱氨溶液肺泡灌洗治疗小儿肺不张的临床效果。方法:选取我院2018年1月至2019年11月收治的60例肺不张的患儿,随机分为对照组(n=30)和观察组(n=30),对照组给予支气管镜肺泡灌洗术治疗,观察组给予支气管镜肺泡灌洗术联合乙酰半胱氨酸溶液肺泡灌洗治疗,比较两组患儿临床疗效、术后肺部啰音消失时间、体温恢复时间、住院时间、需要进行肺泡灌洗的次数及影像学恢复时间、动脉血气指标[动脉血二氧化碳分压(PaCO2)、血氧分压(PaO2)、血氧饱和度(SaO2)]以及不良反应情况。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05);治疗后,观察组肺部啰音消失时间、体温恢复时间、住院时间、需要再次进行肺泡灌洗的次数及病变部位局部的影像学恢复时间等均少于对照组(P<0.05);两组患儿PaCO2降低(P<0.05),PaO2、SaO2升高(P<0.05),观察组优于对照组(P<0.05);治疗期间,两组患儿不良反应比较差异无统计学意义(P>0.05)。结论:支气管镜肺泡灌洗术联合乙酰半胱氨酸溶液肺泡灌洗治疗小儿肺不张疗效确切,可有效改善患儿临床症状,缩短疾病疗程,不增加不良反应
关键词:  支气管镜  肺泡灌洗  乙酰半胱氨酸  儿童  肺不张
DOI:10.13407/j.cnki.jpp.1672-108X.2020.07.004
基金项目:梧州市科学研究与技术开发计划项目,编号201902093
Alveolar Lavage Combined with Acetylcysteine Alveolar Lavage in the Treatment of Atelectasis in Children
Li Dejun1, Chen Xun2, Qin Liyan1, Zhou Tao1, Zhou Yan2, Zeng Yurong1
(1. Wuzhou Gongren Hospital, Guangxi Wuzhou 543001, China; 2. The First Affiliated Hospital of Guangxi Medical University, Guangxi Nanning 530021, China)
Abstract:
Objective: To observe the clinical effects of alveolar lavage combined with inhalation alveolar lavage with acetylcysteine solution in the treatment of atelectasis in children. Methods: Sixty children with atelectasis admitted into our hospital from Jan. 2018 to Nov. 2019 were extracted to be randomly divided into the control group and the observation group, with 30 cases in each group. The control group was given bronchoscopic alveolar lavage, while the observation group received bronchoscopic alveolar lavage combined with inhalation alveolar lavage with acetylcysteine solution. The clinical efficacy, disappearance time of lung rales, recovery time of body temperature, length of stay, times of alveolar lavage and imaging recovery time, arterial blood gas indexes including arterial partial pressure of blood carbon dioxide (PaCO2), partial pressure of blood oxygen (PaO2) and blood oxygen saturation (SaO2), and adverse drug reactions of two groups were compared. Results: The total effective rate in the observation group was significantly higher than that in the control group, with statistically significant difference (P<0.05). After treatment, the disappearance time of lung rales, recovery time of body temperature, length of stay, times of alveolar lavage and imaging recovery time in the observation group were significantly shorter than those in the control group (P<0.05). PaCO2 decreased (P<0.05), and PaO2 and SaO2 increased (P<0.05) in both groups of children, and the observation group was better than the control group (P<0.05). There were no statistically significant difference in the adverse drug reactions between two groups (P>0.05). Conclusion: The efficacy of bronchoscopic alveolar lavage combined with acetylcysteine solution alveolar lavage in the treatment of atelectasis in children is significant, which can effectively improve the clinical symptoms of children and shorten the course of disease without increasing adverse drug reactions
Key words:  bronchoscope  alveolar lavage  acetylcysteine  children  atelectasis

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