| Objective: To analyze the clinical and etiological characteristics of SP in children,and investigate the application value of BAL in diagnosis and treatment of SP in children,so as to provide the basis for the early diagnosis and treatment of SP in children and the clinical application of BAL.Methods: The clinical data of 360 children with SP hospitalized in Minda Hospital of Hubei Minzu University from January 2019 to December 2021 were analyzed retrospectively.The children were divided into four groups according to their ages: ≤1 year old,1～3 years old,3～7years old,and >7 years old.The clinical and etiological characteristics of children with SP were analyzed.According to whether BAL was performed,the children were divided into two groups: lavage group and routine group.The clinical manifestations,pulmonary imaging and inflammatory indicators of the two groups were observed,and the clinical efficacy of BAL on children with SP was analyzed.Results: 1.Children’s SP mainly occurred in winter（40.3%）;The median age was 8（4,27）months.The ratio of male to female was 1.6:1.2.The common clinical symptoms of SP in children were fever（73.3%,264/360）,cough（99.2%,357/360）,wheezing（66.7%,240/360）and shortness of breath（90.8%,327/360）.84.4% of children had complications,the most common complication was respiratory failure（49.4%,178/360）.97.2% of the children had positive pulmonary signs.3.The abnormal rates of SP were 48.3% in WBC,49.2% in ESR,57.5% in CRP and 55.0%in PCT.98.6% of the children had different degrees of infection in imaging,mainly double lung infection（70.8%）.4.The pathogen detection rate was 50%,and 310 strains of pathogens were detected,including 123 strains of bacteria（39.7%）,57 strains of viruses（18.4%）,47 strains of fungi（15.2%）and 83 strains of atypical pathogens（26.7%）.The most common bacteria was streptococcus pneumoniae（11.9%,37/310）.The most common virus was respiratory syncytial virus（6.1%,19/57）.The main atypical pathogen was mycoplasma pneumoniae（26.5%,82/83）.There was no significant difference in bacterial and viral infection among different age groups（P>0.008）.The detection rate of Mycoplasma pneumoniae in 3～7 years old group and >7 years old group was higher than that in ≤ 1 year old group（P<0.008）.5.The pathogen detection rate in lavage group was higher than that in conventional group（P<0.05）;There was no significant difference in thermal regression time between the two groups（P>0.05）.There were significant differences in the relief time of cough and shortness of breath,rales absorption time,the decreased level of inflammation indicators and the area of inflammation absorption in lung imaging between the two groups between the two groups（P<0.05）.In the lavage group,55 cases were effective and 92 cases were effective,the total effective rate was 93.6%.In the conventional group,44 cases were effective and 131 cases were effective,with a total effective rate of 86.2%,the difference between the two groups was statistically significant（P<0.05）.The average length of hospital stay between the two groups was statistically significant（P<0.05）,but no significant difference in average hospitalization cost between the two groups（P>0.05）.There was no significant difference in clinical efficacy between different age groups in lavage group（P>0.05）.Adverse reactions occurred in 3.8%（6/157）of the children in the lavage group.Conclusion: BAL plays an important role in the diagnosis and treatment of SP in children of all ages: The obtained BALF can significantly improve the positive rate of pathogen diagnosis in children with SP,providing a basis for precise treatment of children;significantly improve the clinical symptoms of children;It can significantly reduce the level of inflammatory response in children,effectively relieve lung inflammation and promote the absorption of lung inflammatory lesions in children;It can significantly shorten the hospitalization time of children;The clinical efficacy of BAL diagnosis and treatment was significantly better than conventional treatment,and there were fewer adverse reactions and no serious adverse reactions.BAL is a safe and effective diagnosis and treatment method with good clinical application value. |
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