The Role Of Fiberoptic Bronchoscopy In Diagnosis And Treatment Of Lobar Pneumonia In Children

Part I The effect of fibrobronchoscopy in diagnosis and treatment of different course of lobar pneumonia in childrenObjective:To investigate the effect of bronchoalveolar lavage in diagnosis and treatment of different course of lobar pneumonia in children.Methods:Eighty children with lobar pneumonia were randomly divided into two groups: lavage and control(n=40 each). According to whether the duration of 7 days,lavage group were divided into early lavage group of 17 cases, the late lavage group of 23 cases.The control group received conventional medical treatment. The lavage group was given bronchoalveolar lavage besides conventional medical treatment.The total fever course,cough and rales’ disappearance,antibiotic using time and duration of hospitalization were compared among the different groups.Results:In the total fever course,cough and rales’ disappearance,antibiotic using time and duration of hospitalization,the early group were lower than the rest of the two groups,there is statistically significant among three groups(P<0.05). Only in rales’ disappearance,there is statistically significant between the Late lavage group and the control group(P<0.05).Conclusion:Using bronchoalveolar lavage in treatment of pediatric lobar pneumonia in the early stage(within 7 days)will quickly improve clinical symptoms,shorten the course of the disease.Part II The effect of fiberoptic bronchoscopy and pulmonary Surfactant Injection therapy on lobar pneumonia in childrenObjective:To investigate the effect of bronchoalveolar lavage and pulmonary surfactant injection therapy on lobar pneumonia in children.Methods:120 cases of children with lobar pneumonia during July 2012-December 2014 were enrolled,which are identified in accordance with the diagnostic criteria of lobar pneumonia in the practical pediatrics of Zhu Fu Tang. We devided patients into two groups according to Clinical Pulmonary Infection Score(CPIS)which was recorded on the day of admission,CPIS grades≥6 to divide into the severe group total of 52 cases, the CPIS grading<6 divides into the mild group total of 68 cases. Then we randomly divided the severe group into control group(23 cases)and normal lavage group(14 cases),pulmonary surfactant group(15 cases);the mild group are randomly divided into control group(37 cases)and normal lavaged group(31 cases).The control group received conventional medical treatment. The normal lavage group was given bronchoalveolar lavage besides conventional medical treatment.And the pulmonary surfactant group was given pulmonary surfactant injection therapy besides the normal lavage treatment.Then under the same situation in CPIS score, the total fever course,cough and rales’ disappearance,antibiotic using time and duration of hospitalization were compared among the different groups.Results:In the severe group,In the duration of hospitalization,antibiotic using time,cough and rales’ disappearance,the pulmonary surfactant group were lower than the control group and normal lavage group,there is statistically significant among three groups(P<0.05). Only in the total fever course,there was no statistically significant difference(P > 0.05);In the mild group, in terms of the above differences,there were statistically significant between the normal lavage group and the control group(P<0.05).Conclusion:The fiber bronchoscope were can quickly improve clinical symptoms, shorten the course of the disease;For children with severe lobar pneumonia, PS can be local injected under the endoscopic.