灌洗术联合甲泼尼龙琥珀酸钠治疗小儿重症肺炎的临床疗效

doi:10.3969/j.issn.1004-583X.2026.07.006

摘要/Abstract

摘要：

目的探讨纤维支气管镜灌洗术联合甲泼尼龙琥珀酸钠治疗小儿重症肺炎临床效果。方法回顾性选取2023年8月-2025年10月濮阳市人民医院收治并确诊肺炎的患儿80例,按治疗方式分为对照组(n=40)与观察组(n=40),两组均接受常规抗感染治疗。对照组给予甲泼尼龙琥珀酸钠治疗,观察组在此基础上给予纤维支气管镜灌洗术联合甲泼尼龙琥珀酸钠治疗,观察两组治疗前后指标。结果治疗后观察组肺部啰音、咳嗽、发热症状消退时间均低于对照组(P<0.05);两组治疗后白细胞介素-6、白细胞介素-17、超敏C反应蛋白、降钙素原水平均下降,观察组低于对照组(P<0.05);两组免疫球蛋白A、免疫球蛋白G、免疫球蛋白M水平均升高,观察组高于对照组(P<0.05);观察组不良反应发生率与复发率低于对照组(P<0.05);观察组临床治疗总有效率高于对照组(P<0.05)。结论纤维支气管镜灌洗术联合甲泼尼龙琥珀酸钠治疗小儿重症肺炎效果优于单独治疗,具有良好临床价值。

关键词: 肺炎, 纤维支气管镜灌洗, 甲泼尼龙琥珀酸钠, 疗效, 儿童

Abstract:

Objective To investigate the clinical efficacy of fiberoptic bronchoscopy lavage combined with methylprednisolone sodium succinate in the treatment of severe pneumonia in children. Methods A retrospective analysis was conducted on 80 children diagnosed with pneumonia and treated at Puyang People’s Hospital between August 2023 and October 2025. According to the treatment regimen, the patients were divided into a control group (n=40) and an observation group (n=40). Both groups received conventional anti-infective therapy. The control group was treated with methylprednisolone sodium succinate, while the observation group received fiberoptic bronchoscopy lavage combined with methylprednisolone sodium succinate on this basis. Indicators were observed before and after treatment in both groups. Results After treatment, the resolution times of pulmonary rales, cough, and fever were shorter in the observation group than in the control group (P<0.05). In both groups, the levels of interleukin-6 (IL-6), interleukin-17 (IL-17), high-sensitivity C-reactive protein (hs-CRP), and procalcitonin (PCT) decreased after treatment, with lower levels in the observation group than in the control group (P<0.05). The levels of immunoglobulin A (IgA), immunoglobulin G (IgG), and immunoglobulin M (IgM) increased in both groups, with higher levels in the observation group than in the control group (P<0.05). The incidence of adverse reactions and recurrence rate were lower in the observation group than in the control group (P<0.05). The overall clinical response rate was higher in the observation group than in the control group (P<0.05). Conclusion Fiberoptic bronchoscopy lavage combined with methylprednisolone sodium succinate is more effective than methylprednisolone sodium succinate alone in the treatment of severe pneumonia in children and has favorable clinical value.

Key words: pneumonia, fiberoptic bronchoalveolar lavage, methylprednisolone sodium succinate, therapeutic effect, child

中图分类号:

R563.1

仇晓妤, 杨会阳, 栾晓飞. 灌洗术联合甲泼尼龙琥珀酸钠治疗小儿重症肺炎的临床疗效[J]. 临床荟萃, 2026, 41(7): 614-618.

Qiu Xiaoyu, Yang Huiyang, Luan Xiaofei. Clinical efficacy of bronchoscopic lavage combined with methylprednisolone sodium succinate in the treatment of severe pneumonia in children[J]. Clinical Focus, 2026, 41(7): 614-618.

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链接本文: https://www.lchc.cn/CN/10.3969/j.issn.1004-583X.2026.07.006

https://www.lchc.cn/CN/Y2026/V41/I7/614

图/表 6

参考文献 16

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组别	例数	性别[例(%)]		年龄 (岁)	体质量指数 (kg/m²)	入院体温 (℃)	病原体分布[例(%)]			病程 (d)
组别	例数	男	女	年龄 (岁)	体质量指数 (kg/m²)	入院体温 (℃)	支原体	细菌	病毒	病程 (d)
对照组	40	24(60.0)	16(40.0)	7.58±1.74	14.36±1.15	38.24±0.21	22(55.0)	13(32.5)	5(12.5)	5.42±1.38
观察组	40	27(67.5)	13(32.5)	7.25±1.51	14.18±1.02	38.31±0.18	27(67.5)	8(20.0)	5(12.5)	5.29±1.33
t/χ²值		0.487		0.906	0.741	1.601	1.701			0.429
P值		0.485		0.368	0.461	0.113	0.427			0.669

组别	例数	性别[例(%)]		年龄 (岁)	体质量指数 (kg/m²)	入院体温 (℃)	病原体分布[例(%)]			病程 (d)
组别	例数	男	女	年龄 (岁)	体质量指数 (kg/m²)	入院体温 (℃)	支原体	细菌	病毒	病程 (d)
对照组	40	24(60.0)	16(40.0)	7.58±1.74	14.36±1.15	38.24±0.21	22(55.0)	13(32.5)	5(12.5)	5.42±1.38
观察组	40	27(67.5)	13(32.5)	7.25±1.51	14.18±1.02	38.31±0.18	27(67.5)	8(20.0)	5(12.5)	5.29±1.33
t/χ²值		0.487		0.906	0.741	1.601	1.701			0.429
P值		0.485		0.368	0.461	0.113	0.427			0.669

组别	例数	肺部啰音	咳嗽	发热
对照组	40	6.41±0.66	7.20±0.58	5.83±0.51
观察组	40	4.37±0.42	5.25±0.33	4.14±0.20
t值		16.492	18.482	19.511
P值		<0.01	<0.01	<0.01

组别	例数	肺部啰音	咳嗽	发热
对照组	40	6.41±0.66	7.20±0.58	5.83±0.51
观察组	40	4.37±0.42	5.25±0.33	4.14±0.20
t值		16.492	18.482	19.511
P值		<0.01	<0.01	<0.01

组别	例数	IL-6(ng/L)		IL-17(ng/L)		PCT(μg/L)		hs-CRP(mg/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	40	73.52±8.46	41.68±5.21^*	32.15±4.28	14.27±3.15^*	1.21±0.22	0.51±0.04^*	28.36±2.81	17.24±4.15^*
观察组	40	72.98±8.37	33.42±2.86^*	33.06±4.19	10.43±2.07^*	1.24±0.19	0.38±0.07^*	27.94±2.63	6.86±2.92^*
t值		0.207	8.790	0.961	6.443	0.653	10.198	0.690	12.937
P值		0.775	<0.01	0.340	<0.01	0.516	<0.01	0.492	<0.01