Effects Of Bronchoalveolar Lavage On The Treatment And Lung Function Of Children With Refractory Mycoplasma Pneumoniae Pneumonia

ObjectiveTo explore the value of bronchoalveolar lavage in the treatment of children with refractory mycoplasma pneumoniae pneumonia,and to understand the changes of pulmonary function and the effects of BAL on the changes of pulmonary function In children with RMPP.MethodsA prospective study was conducted to select 75 pediatric patients over the age of 4years who were hospitalized in Children's Hospital of Anhui provincial from April2017 to October 2018 and met the diagnostic criteria of RMPP.According to different treatment methods,the patients were divided into BAL group?conventional treatment+BAL?and conventional treatment group?conventional treatment?.The pediatric patients were given Chest imaging examination?no longer review after normal?and pulmonary function examination at admission,at discharge and 1,3 months after discharge.The duration of cough,fever,lung rale,hospitalization time were compared,match the changes of absorption of pulmonary inflammation and atelectasis,and pulmonary function.Results1.The duration of fever,cough,lung rale,hospitalization time in the BAL group were?6.37±1.35?days,?14.97±2.34?days,?10.75±1.80?days,?12.20±1.70?days,respectively.The duration of fever,cough,lung rale,hospitalization time in the conventional treatment group were?8.86±0.92?days,?18.43±2.43?days,?12.65±1.74?days,and?14.08±1.20?days,respectively.There was significant difference between the two groups.2.In the BAL group and the conventional treatment group,the inflammatory absorption of chest imaging was compared at the time of discharge,at 1 month after discharge,and at 3 months after discharge,P<0.05,the difference was statistically significant.3.In BAL group,there were 19 cases of atelectasis,and 15 cases of pulmonary atelectasis recovery showed by re-examination of imaging examination at discharge,3cases of atelectasis recovery at 1 month after discharge,and 1 case of atelectasis recovery at discharge of 3 month after discharge.In the conventional treatment group,12 cases of atelectasis were observed,3 cases were recovery at discharge,7 cases were recovery at 1 month after discharge,and 2 cases were recovery at 3 months after discharge.Chi-square test showed that the difference was statistically significant.4.Therewere3patients?4.00%?withnormallungfunctionand72patients?96.00%?with abnormal lung function in 75 patients with RMPP,among which mixed ventilation dysfunction accounted for of 46.46%the total number of pulmonary dysfunction,obstructive ventilation dysfunction accounted for 34.67%,restrictive ventilation dysfunction 14.67%.5.Various periods of normal lung function and normal lung function recovery BAL group and the number of cases compared to the conventional treatment group,chi-square test,the difference was statistically significant.The normal recovery rate of lung function in BAL group was higher than that in the conventional treatment group at discharge,1 month after discharge and 3 months after discharge.6.Compared with pulmonary function indexes(FVC?FEV₁?PEF,MMEF?FEF_25%?FEF_50%?FEF_75%)between the children in the BAL group after admission and those at the time of discharge,1 month and 3 months after discharge,P<0.05,indicated a significant difference.7.In the conventional treatment group,the pulmonary function indexes at admission were compared with those of the patients at discharge with PEF and FEF _25%,P>0.05,the difference was not statistically significant,FVC,FEV1,MMEF,FEF_50%,FEF_75%,P<0.05 The difference was statistically significant.Compared with the pulmonary function indexes at 1 month after discharge,FEF _25%,P>0.05,and the difference was not statistically significant.FVC,FEV₁,PEF,MMEF,FEF_50%,FEF_75%,P<0.05,the difference was statistically significant.Compared with the lung function indexes at 3months after admission and hospital discharge,P<0.05,the difference was statistically significant.8.At admission and discharge,there was no significant difference in P>0.05 between children in the BAL group and those in the conventional treatment group in terms of lung function indicators such as FVC,FEV_1,PEF,MMEF,FEF_25%,FEF_50%and FEF_75%.At 1 month after discharge,all the indicators of lung function in the BAL group were compared with those in the conventional treatment group,with P<0.05,and the difference was statistically significant.At 3 months after discharge,FVC,FEV₁,and PEF showed no significant difference,P>0.05,MMEF,FEF_25%,FEF_50%,and FEF_75%,P<0.05,indicating statistically significant difference.Conclusions1.For RMPP children,BAL can promote the disappearance of clinical symptoms,the absorption of lung rale,the improvement of imaging,and the shortening of hospitalization time.2.Most of the children with RMPP have pulmonary dysfunction,and mixed ventilation dysfunction was the most common.BAL significantly improve the lung function of children with RMPP.