乙酰半胱氨酸雾化联合支气管肺泡灌洗治疗肺炎支原体诱导的大叶性肺炎的预后情况分析

Prognosis Analysis of Acetylcysteine Nebulization Combined with Fiber Bronchoscopic Alveolar Lavage in the Treatment of Mycoplasma Pneumoniae-Induced Lobar Pneumoniae

摘要: 目的：观察和评估在肺炎支原体诱导的大叶性肺炎临床治疗过程中应用乙酰半胱氨酸雾化与支气管肺泡灌洗联合治疗对症状积分、炎症应激水平的临床影响作用。方法：本文研究阶段参考双盲法将2023年1月~2024年12月期间收治的120例大叶性肺炎患儿进行分组比对，60例/组，参照组实施支气管肺泡灌洗治疗，实验组在参照组基础上增加乙酰半胱氨酸雾化治疗，比较两组安全性、临床治疗有效率、炎症应激水平[中性粒细胞与淋巴细胞比值(Neutrophil-to-Lymphocyte Ratio, NLR)水平、白细胞计数(White Blood Cell, WBC)、中性粒细胞百分比(Granulocyte Percentage, GRA)、C反应蛋白(C-Reactive Protein, CRP)、降钙素原(Procalcitonin, PCT)]、临床症状缓解时间(肺部湿啰音缓解时间、高热缓解时间、咳嗽缓解时间、住院天数)、症状积分(呼吸困难、胸闷胸痛、发热、咳嗽咳痰)。结果：经研究显示，实验组治疗总有效率98.33%较比参照组更高，差异有统计学意义(P < 0.05)。两组不良反应发生率比较差异无统计学意义(P > 0.05)；实验组WBC、PCT、CRP、NLR、GRA均低于参照组，差异有统计学意义(P < 0.05)；实验组肺部湿啰音缓解时间、高热缓解时间及其咳嗽缓解时间、住院天数较比参照组更短，差异有统计学意义(P < 0.05)；两组治疗后咳嗽咳痰、呼吸困难、胸闷胸痛、发热较比治疗前更低，且实验组低于参照组数据指标，差异有统计学意义(P < 0.05)。结论：将支气管肺泡灌洗联合乙酰半胱氨酸雾化治疗应用在肺炎支原体诱导的大叶性肺炎临床治疗中不仅可显著降低炎症应激水平，改善症状积分，还能够缩短症状缓解时间，提升临床疗效，具有一定安全性。

Abstract: Objective: To observe and evaluate the clinical effects of acetylcysteine nebulization combined with fiberoptic bronchoscopic alveolar lavage on symptom score and inflammatory stress level during the clinical treatment of Mycoplasma pneumoniae-induced lobar pneumoniae. Methods: In this research stage, 120 children with lobar pneumonia admitted from January 2023 to December 2024 were compared with the double-blind method, 60 cases/group, the reference group was treated with fiberoptic bronchoscopic alveolar lavage, and the experimental group was treated with acetylcysteine nebulization therapy on the basis of the reference group, and the safety, clinical treatment efficiency, and inflammatory stress level of the two groups were compared [Neutrophil-to-lymphocyte ratio (Neutrophil-to-Lymphocyte Ratio, NLR) level, White Blood Cell count (WBC), Granulocyte Percentage (GRA), C-Reactive Protein (CRP), Procalcitonin (PCT)], time to remission of clinical symptoms (time to resolution of pulmonary rales, time to remission of hyperthermia, time to remission of cough, number of days in hospital), Symptom points (dyspnea, chest tightness, chest pain, fever, cough and sputum). Results: The total effective rate of treatment in the experimental group was 98.33% higher than that in the reference group, and the difference was statistically significant (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05), the WBC, PCT, CRP, NLR and GRA in the experimental group were lower than those in the reference group (P < 0.05), and the time of resolution of pulmonary rales, the time of relief of hyperthermia and the duration of cough relief and the number of days of hospitalization in the experimental group were shorter than those in the reference group (P < 0.05). The cough and phlegm, dyspnea, chest tightness and chest pain and fever in the experimental group were lower than those before treatment. The experimental group was lower than the reference group, and the difference was statistically significant (P < 0.05). Conclusion: The application of fiberoptic bronchoscopic alveolar lavage combined with acetylcysteine nebulization therapy in the clinical treatment of Mycoplasma pneumoniae-induced lobar pneumonia can not only significantly reduce the level of inflammatory stress and improve symptom scores, but also shorten the time of symptom relief and improve clinical efficacy, which has certain safety.