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Clinical application of fiber bronchoscope in the treatment of pediatric Mycoplasma Pneumoniae pneumonia |
WANG Long-hui NING Ning KUANG Yun DING Guo-biao WU Xiao-ling LI Hai-yan |
Department of Pediatrics,Maternal and Child Health Care Hospital,Jiangxi Province,Jiujiang 332000,China |
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Abstract ObjectiveTo explore the clinical application value of fiberbronchoscopy and bronchoalveolar lavage(BAL) in the treatment of Mycoplasma Pneumoniae pneumonia (MPP)children.MethodsTotally 123 children with segmental MPP and pulmonary atelectasis,who was hospitalized and underwent fiberbronchoscopy and BAL in the Pediatrics Department of our hospital from June 2015 to March 2017 were selected as the BAL group;52 children with segmental MPP complicated with atelectasis and whose family members of children with different purposes of fiberoptic bronchoscopy or BAL in our hospital department during the same period were selected as the control group.According to the random number,the BAL group was divided into two groups:62 cases with the odd number and treated with warm saline (37℃,0.5 ml/kg per time)as the NS group;61 cases with even numbers and and treated with warm NS (37℃,0.5 ml/kg per time)+Mucosolvan(1 mg/kg per time)as the Mucosolvan group.The fever time,hospital stay,hospital expenses,treatment total efficiency and so on of each group was compared.ResultsThere was mucosal congestion and edema of different degrees were found by fiberbronchoscopy in all children of the BAL group,mucosalfollicular hyperplasia in 20.3%cases, phlegm embolus in 15.4%cases,mucosal swelling,congestion and secondary stenosis in 26.0%cases,mucosal erosion in 4.1%cases,and congenital airway constriction in 2.4%cases.The fever time of BAL group was(5.6±1.4)d,hospitalization time was(13.3±1.7)d,medical expenses was(10 425.5± 121.8)yuan,the control group fever time was(8.3±1.7)d, hospitalization time was(15.7±1.5)d,medical expenseswas(11 034.7±148.3)yuan,and the BAL group was less than the control group(P<0.05);the effective rate of BAL group was 98.4%,the control group was 88.5%,so the BAL group was significantly higher than that of the control group (P<0.05).The fever time of Mucosolvan group was(5.5±1.6)d,NS group was(5.7±1.2)d,there were no significant differences between the two groups(P>0.05).But the hospitalization time and medical cost in Mucosolvan group were(12.9±1.5)d and(10 122.5±125.7)yuan,both lower than those in NS group[(13.9±1.8)d,(10 725.3±109.5)yuan,(P<0.05).The total effective rate was 98.4%in the two groups.ConclusionFiberbronchoscopy enables the detection of tracheal mucosal injury in children with segmental MPP,which provides better guidance for treatment.BAL can shorten the fever time and hospitalization time,reduce the medical costs and improve the therapeutic effect;and BAL with Mucosolvan Injection as solvent can further shorten the hospitalization time and reduce the medical costs.
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