2026 年第 9 期 第 21 卷

支气管肺泡灌洗联合经鼻持续气道正压通气治疗儿童重症肺炎的效果观察

Observation on the efficacy of bronchoalveolar lavage combined with nasal continuous positive airway pressure in the treatment of severe pneumonia in children

作者：金月1张文利2李丽3王昕1

英文作者：Jin Yue1 Zhang Wenli2 Li Li3 Wang Xin1

单位：1河北省沧州市人民医院新生儿科，沧州061000；2河北省沧州市中心医院儿童急诊医学部，沧州061000；3河北省沧州市人民医院儿科二区，沧州061000

英文单位：1Department of Neonatology Cangzhou People′s Hospital Hebei Province Cangzhou 061000 China; 2Department of Pediatric Emergency Medicine Cangzhou Central Hospital Hebei Province Cangzhou 061000 China; 3Second Ward Department of Pediatrics Cangzhou People′s Hospital Hebei Province Cangzhou 061000 China

关键词：儿童重症肺炎；支气管肺泡灌洗；经鼻持续气道正压通气；肺功能；凝血功能

英文关键词：Severepneumoniainchildren;Bronchoalveolarlavage;Nasalcontinuouspositiveairwaypressure;Pulmonaryfunction;Coagulationfunction

• 摘要：

• 目的 探讨支气管肺泡灌洗联合经鼻持续气道正压通气治疗儿童重症肺炎的效果。方法 选取2021年6月至2024年2月在河北省沧州市人民医院接受治疗的136例重症肺炎患儿作为研究对象。按随机抽签法分为常规组和联合组，每组68例。常规组在基础管理治疗基础上使用经鼻持续气道正压通气治疗，联合组在常规组基础上加用支气管肺泡灌洗治疗。比较2组肺功能、凝血功能指标、血气指标、炎症因子水平、疗效及安全性。结果 治疗后2组呼气峰流速、达峰时间比、功能残气量均高于治疗前，活化部分凝血活酶时间、凝血酶原时间均长于治疗前，动脉血氧分压、氧合指数均高于治疗前，且联合组均高于/长于常规组；纤维蛋白原、动脉血二氧化碳分压、白细胞介素10、白细胞介素6、肿瘤坏死因子α水平均低于治疗前，且联合组均低于常规组，差异均有统计学意义（均P<0.05）。联合组总有效率高于常规组［88.2%（60/68）比73.5%（50/68）］，差异有统计学意义（P<0.05）。联合组与常规组并发症总发生率比较差异无统计学意义［2.9%（2/68）比8.8%（6/68）］（P>0.05）。结论 支气管肺泡灌洗联合经鼻持续气道正压通气治疗儿童重症肺炎，可以有效提升效果，改善患儿的肺功能、血气指标、凝血功能，降低炎症因子水平。

• Objective To explore the efficacy of bronchoalveolar lavage combined with nasal continuous positive airway pressure in the treatment of severe pneumonia in children. Methods A total of 136 children with severe pneumonia treated in Cangzhou People′s Hospital, Hebei Province from June 2021 to February 2024 were selected as research subjects. The children were divided into routine group and combined group by random drawing, with 68 cases in each group. The routine group was treated with nasal continuous positive airway pressure on the basis of basic supportive treatment, while the combined group received additional bronchoalveolar lavage on the basis of the routine group. Pulmonary function, coagulation function indicators, blood gas indicators, levels of inflammatory factors, clinical efficacy and safety were compared between the two groups. Results After treatment, the peak expiratory flow, ratio of time to peak tidal expiratory flow, functional residual capacity in both groups were higher than those before treatment; activated partial thromboplastin time and prothrombin time were prolonged; arterial partial pressure of oxygen and oxygenation index were elevated, and all indicators in the combined group were superior to those in the routine group. The levels of fibrinogen, arterial partial pressure of carbon dioxide, interleukin-10, interleukin-6 and tumor necrosis factor-α were lower than those before treatment, and the combined group had lower levels than the routine group (all P<0.05). The total effective rate of the combined group was higher than that of the routine group ［88.2%(60/68) vs 73.5%(50/68)］(P<0.05). There was no statistically significant difference in the total incidence of complications between the combined group and the routine group ［2.9%(2/68) vs 8.8%(6/68)］(P>0.05). Conclusion Bronchoalveolar lavage combined with nasal continuous positive airway pressure can effectively improve the therapeutic effect for children with severe pneumonia, ameliorate pulmonary function, blood gas indexes and coagulation function, and reduce the levels of inflammatory factors.