支气管肺泡灌洗联合俯卧位治疗儿童肺炎支原体肺炎伴肺不张疗效的前瞻性随机对照研究OACSTPCD
Efficacy of bronchoalveolar lavage combined with prone positioning in children with Mycoplasma pneumoniae pneumonia and atelectasis:a prospective randomized controlled study
目的 探讨支气管肺泡灌洗(bronchoalveolar lavage,BAL)联合俯卧位在儿童肺炎支原体肺炎(Mycoplasma pneumoniae pneumonia,MPP)伴肺不张中的疗效及对肺功能的影响.方法 前瞻性选取2020年11月—2023年5月在内蒙古鄂尔多斯市中心医院住院治疗的94例MPP伴肺不张的患儿为研究对象,随机分为治疗组和对照组,每组各47例.治疗组在常规治疗及BAL基础上加以俯卧位治疗,对照组给予常规治疗及BAL.比较两组患儿发热、肺部体征、住院时间、肺复张和肺功能改善情况.结果 治疗组肺部体征改善时间、住院时间短于对照组,住院第7天、出院当天及出院后1周肺复张有效率高于对照组(P<0.05).治疗组出院当天及出院后1周用力肺活量占预测值百分比、第1秒用力呼气量占预测值百分比、第1秒用力呼气量/用力肺活量、用力呼出50%肺活量的呼气流量占预测值百分比、用力呼出75%肺活量的呼气流量占预测值百分比及最大呼气中期流量占预测值百分比均高于对照组(P<0.05).两组患儿体温降至正常时间比较差异无统计学意义(P>0.05).结论 BAL联合俯卧位在儿童MPP伴肺不张治疗中,有利于缩短肺部体征改善时间及住院时间,有利于肺复张和肺功能的改善.
Objective To study the efficacy of bronchoalveolar lavage(BAL)combined with prone positioning in children with Mycoplasma pneumoniae pneumonia(MPP)and atelectasis and its effect on pulmonary function.Methods A prospective study was conducted on 94 children with MPP and atelectasis who were hospitalized in Ordos Central Hospital of Inner Mongolia from November 2020 to May 2023.The children were randomly divided into a treatment group and a control group,with 47 children in each group.The children in the treatment group were given conventional treatment,BAL,and prone positioning,and those in the control group were given conventional treatment and BAL.The two groups were compared in terms of fever,pulmonary signs,length of hospital stay,lung recruitment,and improvement in pulmonary function.Results Compared with the control group,the treatment group had significantly shorter time to improvement in pulmonary signs and length of hospital stay and a significantly higher rate of lung recruitment on day 7 of hospitalization,on the day of discharge,and at 1 week after discharge(P<0.05).Compared with the control group,the treatment group had significantly higher levels of forced vital capacity(FVC)as a percentage of the predicted value,forced expiratory volume(FEV)in 1 second as a percentage of the predicted value,ratio of FEV in 1 second to FVC,forced expiratory flow at 50%of FVC as a percentage of the predicted value,forced expiratory flow at 75%of FVC as a percentage of the predicted value,and maximal mid-expiratory flow as a percentage of the predicted value on the day of discharge and at 1 week after discharge(P<0.05).There was no significant difference in the time for body temperature to return to normal between the two groups(P>0.05).Conclusions In the treatment of children with MPP and atelectasis,BAL combined with prone positioning can help to shorten the time to improvement in pulmonary signs and the length of hospital stay and promote lung recruitment and improvement in pulmonary function.
萨日娜;王爱琼;高有汉;李晓安;呼格吉乐图
鄂尔多斯市中心医院普儿科,内蒙古鄂尔多斯 017000鄂尔多斯市中心医院普儿科,内蒙古鄂尔多斯 017000||内蒙古医科大学研究生学院,内蒙古呼和浩特 010059鄂尔多斯市中心医院康复科,内蒙古鄂尔多斯 017000
肺炎支原体肺炎支气管肺泡灌洗俯卧位肺不张儿童
Mycoplasma pneumoniae pneumoniaBronchoalveolar lavageProne positioningAtelectasisChild
《中国当代儿科杂志》 2024 (001)
31-36 / 6
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