The Clinical Application Of Fiberoptic Bronchoscopy In Diagnosis And Treatment Of Lobar Pneumonia In Children

Objective To investigate the clinical application value and the curative effect of bronchoalveolar lavage(BAL) in the diagnosis and treatment of lobar pneumonia in children, and improve the diagnosis and treat level of lobar pneumonia in children and broaden application range of fiberoptic bronchoscopy in children with respiratory tract diseases.Methods(1) 78 children with lobar pneumonia were enrolled from department of pediatric respiration at the First People’s Hospital of Chenzhou from January 2014 to December 2015.(2) The enrolled infants were divided into experimental group(n=46) and control group(n=32) according to whether conduct of fiberoptic bronchoscopy alveolar lavage or not.(3) Patients in the control group were received conventional treatment, including anti-infective therapy, atomization, resolve phlegm and other treatment; the experimental group were received the conventional treatment and supplemented by fiber bronchoscopy alveolar lavage treatment.(4) The therapeutic effects were observed on the two groups, including the improvement of symptoms, lung rale, inflammatory biomarkers, pulmonary function, lung CT, the duration of hospital stays and hospital costs.Results(1) 78 children with lobar pneumonia were enrolled and were divided into experimental group(n=46) and control group(n=32). There have no significant differences of the age, height, weight and gender composition between the two groups(P>0.05).(2) There have no significant differences of fever, cough, dyspnea, lung rales, atelectasis, pulmonary consolidation, emphysema, pleural effusion and white blood cell(WBC), C-reactive protein(CRP) and procalcitonin(PCT) level between the two groups(P > 0.05).(3) Comparing with control group, the course of fever, cough, lung rales and the recovery time of WBC and CRP were shorter in the experimental group(P < 0.05). And there was no significant difference in the recovery time of PCT between the two groups(P > 0.05).(4) The absorption of lung inflammation in the lung CT is more obvious in the experimental group than control group after seven days treatment.(5) Comparing with control group, the duration of hospital stays were shorter and the hospital costs were lower in the experimental group(P < 0.001).(6) There was no significant difference in pulmonary function between two groups before treatments(P>0.05); 7 days after the treatment, the pulmonary function were significantly improved in two groups(P < 0.001) and more obviously in the experimental group(P<0.001).(7) The main bacteria detection in the two groups were Streptococcus pneumoniae, Staphylococcus aureus, Staphylococcus aureus, Klebsiella pneumoniae, Streptococcus pneumoniae and Escherichia coli. And the main virus detection is respiratory syncytial virus, influenza virus and adenovirus. The bacterial detection rate was higher in the experimental group than the control group(P=0.035), and there was no significant difference in the detection rate of virus and Mycoplasma in the two group(P > 0.05).(8) Using Bronchoalveolar lavage to treat lobar pneumonia result in less complications and has good security.Conclusion(1) Combined conventional treatment with fiberoptic bronchoalveolar lavage in children with lobar pneumonia can improve the clinical symptoms and the absorption of lung inflammation, improve the lung function and the recovery of the disease.(2) Combined conventional treatment with fiberoptic bronchoalveolar lavage in children with lobar pneumonia can shorten the course of disease, decrease the cost of hospitalization and reduce the economic burden of the families of the children.(3) Fiberoptic bronchoscopy lavage is contributed to the diagnosis of etiology, and can guide clinical medication.(4) Using Bronchoalveolar lavage to treat lobar pneumonia has good security.