Bronchoscopic characteristics of severe mycoplasma pneumoniae pneumonia in children
Li Dandan, Li Pan, Liu Xinfeng, et al
(1. Department ofⅣ Respiratory, Hebei Children's Hospital, Hebei, Shijiazhuang 053000, China; 2. Neonatal Intensive CareUnit, the Seventh Medical Center of PLA General Hospital, Faculty of Pediatrics, the Chinese PLA General Hospital, Beijing 100700, China)
Abstract: 【Abstract】 Objective To investigate the bronchoscopic characteristics of severe mycoplasma pneumoniae pneumonia (SMPP) in children, and to provide reference for clinical diagnosis and treatment. Method A total of 168 children with SMPP who were hospitalized in the Department of Respiratory, Hebei Children's Hospital from January 2020 to December 2021 and underwent bronchoscopy and alveolar lavage were selected as the study objects, and they were divided into the infant group (≤3 years old, n=58), and the children group (3-≤14 years old, n=110) according to the age. The clinical symptoms and imaging data of the two groups were compared, and the characteristic changes under bronchoscopy and clinical prognosis were analyzed.The statistical methods performed by t-test, χ2 test or Fisher exact probability method. Result The fever days in the children group and the infant group were (7.75±2.79) vs (5.78±1.77) days, and the maximum body temperature was (39.40±1.15) vs (37.91±0.39) ℃, respectively, which were higher in the children groupthan those in the infant group (χ2 value was -5.609 and -12.323, all P<0.001). In addition, sputum [30.0%(33/110) vs 100% (58/58)], wheezing [15.5% (17/110) vs 77.6% (45/58)], dyspnea [10.9% (12/110) vs25.9% (15/58)] and vomiting [6.4% (7/110) vs 41.4% (15/58)], the above data in the children group weresignificantly lower than those in the infant group (χ2value was 74.954, 62.959, 6.295, 30.944, all P<0.05). Theresults of CT showed that the bulk of solid lesions and necrotic images only occurred in the children group;small spots [72.4% (42/58) vs 18.2% (20/110)] and ground glass changes [65.5% (38/58) vs 27.3% (30/110)]in the infant group were significantly higher than those in the child group with statistical significance(χ2value 47.967, 23.055, all P<0.001). Bronchoscopic mucosal erosion and necrosis [46.4% (51/110) vs 3.4%(2/58)] and mucous embolus obstruction [45.5% (50/110) vs 20.7% (12/58)] were significantly higher in thechildren group than those in the infant group (χ2value was 32.388, 10.002, all P<0.05), nodular protrusionand shape formation were only found in the children group. The infant group did not receive interventional treatment, and in the children group, 18.2% (20/110) received interventional treatment. Conclusion Thebronchoscopic characteristics of SMPP in children of different ages are different. The children group mostly presents with mucosal erosion and necrosis, nodular protrusion, mucous thrombus obstruction and plasticformation, and the infant group often has flocculent secretions, which can be used as a reference for clinical diagnosis and treatment and prognostic evaluation.
李丹丹 李攀 刘新锋 郎艳美 马铮 石艳玺 张艳平. 儿童重症肺炎支原体肺炎的支气管镜镜下特征分析[J]. 发育医学电子杂志, 2023, 11(5): 352-358.
Li Dandan, Li Pan, Liu Xinfeng, et al. Bronchoscopic characteristics of severe mycoplasma pneumoniae pneumonia in children. Journal of Developmental Medicine(Electronic Version), 2023, 11(5): 352-358.
2023, Vol. 11 
