Clinical efficacy of bronchoscopic lavage combined with methylprednisolone sodium succinate in the treatment of severe pneumonia in children

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

Abstract

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

CLC Number:

R563.1

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.

Add to citation manager EndNote|Ris|BibTeX

URL: https://www.lchc.cn/EN/10.3969/j.issn.1004-583X.2026.07.006

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

Figures/Tables 6

References 16

[1]	莫亚玲, 赵德运. 不同治疗方案对合并反复呼吸道感染史儿童重症社区获得性肺炎的效果观察[J]. 实用临床医药杂志, 2024, 28(6): 51-55.doi:10.7619/jcmp.20234061.
[2]	王春雨, 李亚, 王家豪. 小潮气量机械通气和人免疫球蛋白联合治疗儿童重症肺炎疗效观察[J]. 新乡医学院学报, 2024, 41(10): 930-934.doi:10.7683/xxyxyxb.2024.10.006.
[3]	Zheng K, Zhou SH, Han ZB. Clinical efficacy comparison of Doxycycline versus Azithromycin combined with Methylprednisolone in the treatment of macrolide-unresponsive Mycoplasma pneumoniae pneumonia in children[J]. Eur J Clin Microbiol Infect Dis, 2026, 45(4):1059-1067. doi:10.1007/s10096-025-05393-1.
[4]	胡高声, 王夏林. 人免疫球蛋白联合甲泼尼龙治疗儿童重症肺炎的疗效评价[J]. 儿科药学杂志, 2023, 29(7): 28-30.doi:10.13407/j.cnki.jpp.1672-108X.2023.07.008.
[5]	高霞, 方钰, 张珊, 等. 成都地区社区获得性肺炎儿童重症现状及相关因素分析[J]. 华南预防医学, 2024, 50(5): 452-454.doi:10.12183/j.scjpm.2024.0452.
[6]	尤玉婷, 曾丽娥, 林春燕, 等. 儿童重症肺炎支气管肺泡灌洗液的病原菌及药敏试验分析[J]. 检验医学与临床, 2024, 21(2): 213-216.doi:10.3969/j.issn.1672-9455.2024.02.016.
[7]	世界中医药学会联合会内科专业委员会, 李建生, 余学庆. 社区获得性肺炎中西医结合诊疗指南[J]. 中国循证医学杂志, 2025, 25(1): 32-41.doi: 10.7507/1672-2531.202408103.
[8]	中华人民共和国国家健康委员会. 儿童社区获得性肺炎诊疗规范(2019年版)[J]. 临床医学研究与实践, 2019, 4(6): 201.doi: 10.3760/cma.j.issn.1674-2397.2019.01.002.
[9]	Zhu M, Lu Z, Liao X, et al. Clinical value of dysregulated miR-125b-5p in severe pneumonia children[J]. BMC Immunol, 2025, 26(1):31. doi:10.1186/s12865-025-00707-6. pmid: 40221643
[10]	Cao S, Liu L, Yang L, et al. Assessing severe pneumonia risk in children via clinical prognostic model based on laboratory markers[J]. Int Immunopharmacol, 2025, 151:114317. doi:10.1016/j.intimp.2025.114317.
[11]	贾苗辉, 张亚芳, 冀虎, 等. 应用不同剂量的甲泼尼龙辅助治疗小儿重症肺炎的临床疗效及分析评价[J]. 现代消化及介入诊疗, 2022, (S01):0736-0736.
[12]	Ji X, Fu H, Zhang F, et al. Efficacy of budesonide suspension in the treatment of lobar pneumonia by fiberoptic bronchoscopic alveolar lavage[J]. Front Med (Lausanne), 2025, 12:1598234.doi:10.3389/fmed.2025.1598234.
[13]	Wu X, Lu W, Wang T, et al. Optimization strategy for the early timing of bronchoalveolar lavage treatment for children with severe mycoplasma pneumoniae pneumonia[J]. BMC Infect Dis, 2023, 23(1):661. doi:10.1186/s12879-023-08619-9. pmid: 37798699
[14]	唐华兵, 周浩泉, 吕勇, 等. 纤维支气管镜在儿童异基因造血干细胞移植术后合并重症肺炎中的治疗价值[J]. 临床肺科杂志, 2022, 27(9):1320-1324.
[15]	Ma W, Wang Y, Dang Q, et al. Factors based on Cox regression modeling to analyze the prognostic impact of fiberoptic bronchoscopic bronchoalveolar lavage on children with severe pneumonia[J]. Am J Transl Res, 2024, 16(12):7645-7655. doi:10.62347/OGZD3131. pmid: 39822555
[16]	Pei M, Jiang P, Wang T, et al. Effect of bronchoalveolar lavage on the clinical efficacy, inflammatory factors, and immune function in the treatment of refractory pneumonia in children[J]. Transl Pediatr, 2021, 10(4):921-928. doi:10.21037/tp-21-89. pmid: 34012841

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