纤维支气管镜下支气管肺泡灌洗治疗儿童重症支原体肺炎的效果观察[摘要]目的探?纤维支气管镜下支气管肺泡灌洗治疗儿童重症支原体肺炎的应用价值。方法选取我院2015年1月～2016年12月住院儿童经X线胸片、CT及实验室指标证实为重症支原体肺炎100例作为研究对象，且经纤维支气管镜除外异物、畸形、肿瘤、结核等，明确为感染所致。根据治疗方法不同分为两组，观察组和常规组各50例。常规组用呼吸机辅助呼吸、抗感染、营养支持及对症治疗，观察组行床旁纤维支气管镜吸痰、灌洗、注药治疗。观察两组的疗效、安全性。结果观察组治疗有效率为96.0%，对照组治疗有效率为76.0%，差异有统计学意义（P<0.05）；在咳嗽、胸疼、肺部??音、肺部X线吸收时间比较，观察组较对照组明显缩短，差异有统计学意义（P<0.01）；观察组发生并发症2例，并发症发生率为4.0%，鼻出血及术后发热各1例，给予对症治疗后明显改善、好转。对照组无并发症发生，两组并发症发生率比较差异无统计学意义（P>0.05）。结论纤维支气管镜下支气管肺泡灌洗对小儿重症支原体肺炎有明显的治疗作用，且安全、有效。[关键词]纤维支气管镜；支气管肺泡灌洗；儿童；重症支原体肺炎[]R725.6[文献标识码]A[]1674-4721（2017）09（a）-0107-03EffectobservationonbronchoalveolarlavageinthetreatmentofsevereMycoplasmapneumoniainchildrenunderfiberbronchoscopeLIUQing-biao1LUOHui-chang2XUBo-hua1LIShi-yu1ZHANGYu-ling11.DepartmentofPediatrics，theDonghuaHospitalAffiliatedtoSunYat-senUniversity，GuangdongProvince，Dongguan523110，China；2.DepartmentofHemodialysisRoom，theDonghuaHospitalAffiliatedtoSunYat-senUniversity，GuangdongProvince，Dongguan523110，China[Abstract]ObjectiveToexploretheapplicationvalueofbronchoalveolarlavageinthetreatmentofsevereMycoplasmapneumoniainchildrenunderfiberbronchoscope.MethodsAtotalof100pediatricpatientswhowerediagnosedwithsevereMycoplasmalpneumoniabyX-ray，CTandlaboratoryindicatorsinourhospitalfromJanuary2015toDecember2016wereselectedasresearchobjects.Theetiologywasexclusivelyduetoinflammationbyfiberbronchoscoperulingoutofforeignsubstance，deformity，tumor，andnodule.Accordingtodifferenttherapeuticmethods，theyweredividedintotwogroups.Regularapplicationsofventilator-assistedrespiration，anti-infection，nutritionalsupport，andsymptomatictreatmentwereprovidedinbothgroups.Inobservationgroup（n=50），bedsidesputumsuctionbyfiberbronchoscope，lavage，anddruginjectionwereprovided，whileincontrolgroup（n=50），sputumsuctiontubeandhumidifyingfortreatmentwereadopted.Theeffectandsafetyinthetwogroupswereobserved.ResultsThetherapeuticeffectiveratewas96.0%intheobservationgroupand76.0%inthecontrolgroup，withastatisticaldifferencebetweenthetwogroups（P<0.05）.Incomparisonwiththecough，chestpain，lungrale，andtimeofX-rayabsorptioninthelung，thoseintheobservationgroupweremuchshorterthanthoseinthecontrolgroup，whichweredisplayedstatisticaldifferences（P<0.01）.Intheobservationgroup，2caseswereoccurredwiththecomplications，including1caseofnasalbleedingand1caseofpostoperativefever，accountingfor4.0%inall.Thecomplicationswereimprovedaftersymptomatictreatment.Nocomplicationsoccurredinthecontrolgroup，whichwasnotdisplayedastatisticaldifferenceaftercomparison.ConclusionUnderfiberbronchoscope，bronchoalveolarlavagehasaremarkableeffectonseveremycoplasmapneumoniainchildren，whichissafeandeffective.[Keywords]Fiberbronchoscope；Bronchoalveolarlavage；Children；SevereMycoplasmapneumonia近年来，儿童支原体肺炎发病年龄呈小龄化，感染率呈直线上升，且发病隐匿、症状不典型、病程长[1]，儿童支原体肺炎可导致患儿出现肺部病变，甚至心肌炎等...