Analysis of high risk factors of bronchiolitis obliterans in children after infection and evaluation of the efficacy of bronchoscopic alveolar lavage combined with hormone nebulization
Objective To explore the high risk factors of post-infectious bronchiolitis obliterans(PIBO)in children,and to evaluate the efficacy of bronchoscopic alveolar lavage combined with hormone nebulization in the treatment of PIBO in children.Methods 5705 children with pulmonary infection were selected,including 100 children with PIBO.Univariate and Logistic regression analysis were used to analyze the high risk factors of PIBO.A total of 100 children with PIBO were randomly divided into the lavage group and the nebulization group,with 50 cases in each group.The nebulization group received nebulization treatment with hormone(pulmicort),and the lavage group received nebulization treatment with hormone(pulmicort)and bronchoscopic alveolar lavage.The clinical efficacy of two groups was compared.Results Univariate and Logistic regression analysis showed that heat duration＞12 days,pulmonary wheeze,dyspnea,use of non-invasive mechanical ventilation,concurrent adenovirus,wheezer and respiratory failure were the high risk factors for PIBO in children(P＜0.05).The relief time of shortness of breath,wheezer,cough and pulmonary rales in the lavage group was shorter than that in the nebulization group(P＜0.05).The levels of white blood cell(WBC),C-reactive protein(CRP)and procalcitonin(PCT)in two groups after treatment were lower than those before treatment(P＜0.05),and the lavage group was lower than the nebulization group(P＜0.05).The tidal volume(TV),time to peak tidal expiratory flow as a proportion of expiratory time(TPTEF/TE)and volume to peak expiratory flow as a proportion of exhsled volume(VPEFNE)in two groups after treatment were higher than those before treatment(P＜0.05),and the lavage group was higher than the nebulization group(P＜0.05).The effective rate of the lavage group(96.00％,48/50)was higher than that of the nebulization group(84.00％,42/50)(P＜0.05).Conclusion PIBO in children with pulmonary infection is associated with a variety of high risk factors.Bronchoscopic alveolar lavage combined with nebulization treatment with hormone(pulmicort)can improve clinical symptoms,imflammatory response,and lung tidal function of children with PIBO,and can enhance clinical efficacy.
万方数据
维普
