目的:探讨电子支气管镜肺泡灌洗辅助治疗对难治性肺炎支原体肺炎(RMPP)患儿疗效、肺表面活性蛋白、乳酸脱氢酶(LDH)、穿透素3(PTX3)水平及血气指标的影响。方法:回顾性收集本院2016年10月至2022年6月收治的RMPP患儿97例,根据采取的治疗方案不同,分为药物治疗组(48例)和肺泡灌洗组(49例)。药物治疗组采用常规的大环内酯类为主的抗感染治疗及对症治疗,肺泡灌洗组在药物治疗组的基础上,给予支气管镜支气管肺泡灌洗治疗。对比两组患儿的疗效、治疗前后肺表面活性蛋白A(SP-A)、肺表面活性蛋白D(SP-D)、LDH、PTX3水平及血气分析相关指标。结果:肺泡灌洗组的总有效率为89.80 %,明显高于药物治疗组(70.83 %)(P＜0.05)。治疗前,两组患儿SP-A、SP-D、LDH、PTX3水平及血气分析指标比较,无显著差异(P＞0.05)。治疗后,肺泡灌洗组患儿SP-A、SP-D、LDH、PTX3水平明显低于药物治疗组,血气指标明显优于药物治疗组(P＜0.05)。肺泡灌洗组患儿不良反应发生率(10.00 %)明显低于药物治疗组(26.00 %)(P＜0.05)。结论:采用支气管镜支气管肺泡灌洗辅助药物治疗RMPP具有较好的疗效,可显著改善患儿肺的血气指标,降低肺表面活性蛋白(SP-A、SP-D)、LDH、PTX3水平,且安全性高。

Objective: To analyze the effect of the adjuvant therapy with bronchoalveolar lavage, pulmonary surfactant protein,lactate dehydrogenase (LDH), penetrating hormone 3 (PTX3) level, and arterial blood gas indexes in children with refractory mycoplasma pneumonia (RMPP). Methods: Clinical data of 97 children with RMPP in our hospital from October 2016 to June 2022 were collected retrospectively, and divided into the drug treatment group (48 cases) and bronchoalveolar lavage group (49 cases) according to the different treatment methods. The children in the drug treatment group were treated with macrolide for anti-infection and symptomatic treatment. The children in the bronchoalveolar lavage group were treated with bronchoscopic bronchoalveolar lavage on the basis of the drug treatment group. The curative effect, the levels of pulmonary surfactant protein A (SP-A), pulmonary surfactant protein D (SP-D), LDH and PTX3 and arterial blood gas indexes before and after treatment of the two groups were compared. Results: The total effective rate in the bronchoalveolar lavage group was 89.80 %, which was obviously higher than that in the drug treatment group (70.83 %) (P＜0.05). Before treatment, the levels of SP-A, SP-D, LDH, PTX3 and arterial blood gas indexes had no significant difference between the two groups (P＞0.05). After treatment, the levels of SP-A, SP-D, LDH and PTX3 in the bronchoalveolar lavage group were obviously lower than those in the drug treatment group, and the arterial blood gas indexes were obviously better than those in the drug treatment group (P＜0.05). The incidence of adverse reactions in the bronchoalveolar lavage group (10.00 %) was obviously lower than the drug treatment group (26.00 %) (P＜0.05). Conclusion: The adjuvant therapy with bronchoalveolar lavage in the treatment children with RMPP has a good treatment effect, which could significantly improve the arterial blood gas indexes and lower the levels of pulmonary surfactant protein (SP-A, SP-D), LDH and PTX3 with high safety.