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Received:November 16, 2025 Published Online:May 01, 2026
Received:November 16, 2025 Published Online:May 01, 2026
中文摘要: 目的 探讨支气管镜下塑型栓的不同取出方式在塑型性支气管炎（PB）患儿治疗中的应用效果。方法 选取2023年8月至2024年12月徐州医科大学附属徐州儿童医院150例PB患儿为研究对象，根据支气管塑型栓的不同取出方式，随机分为负压吸引组、活检钳钳取组和毛刷刷取组，各50例。 观察支气管镜术前、术后3组患儿动脉血氧分压（PaO2）、二氧化碳分压（PaCO2），术后血清炎性因子［白细胞介素（IL）-6、IL- 1β、肿瘤坏死因子α（TNF-α)、降钙素原（PCT）］水平的变化，术后并发症发生情况。 结果 术后，3组PaO2水平相较于术前均升高（P<0.05），同时负压吸引组PaO2水平为（83.75 ± 6.37）mmHg，分别高于活检钳钳取组（78.34±6.16）mmHg和毛刷刷取组（79.51±5.96）mmHg（P<0.05）；3组PaCO2水平相较于术前均降低（P<0.05），同时负压吸引组PaCO2水平为（44.15 ± 3.12）mmHg，低于活检钳钳取组（46.56 ±4.98）mmHg（P<0.05）。 3组 TNF-α、IL-6、IL-1β、PCT水平相较于术前均降低（P<0.05），同时3组间以上指标负压吸引组较低（P<0.05）。机械操作相关并发症中，3组间仅黏膜损伤发生率差异有统计学意义(χ2=7.891，P=0.019），其中负压吸引组低于毛刷刷取组（8.00% vs 30.00%，χ2=7.861，P<0.017）；其他并发症3组间差异无统计学意义（P>0.05）。结论 儿童PB治疗中负压吸引对患儿血氧影响最小且炎症反应最轻，并发症较少，可作为PB患儿塑型栓取出的优先选择。
Abstract:Objective To explore the application effects of different removal Methods of plastic casts under bronchoscopy in the treatment of children with plastic bronchitis（PB）. Methods A total of 150 children with PB from Xuzhou Children's Hospital affiliated to Xuzhou Medical University from August 2023 to December 2024，were selected as the research subjects. According to the different removal Methods of the bronchial plastic casts，they were randomly divided into the negative pressure suction group，the biopsy forceps removal group，and the brush removal group，with 50 cases in each group. The level changes of arterial blood partial pressure of oxygen（PaO2），partial pressure of carbon dioxide（PaCO2）preoperatively and postoperatively，and serum inflammatory factors such as interleukin（IL）-6，IL- 1β,tumor necrosis factor alpha（TNF-α),and procalcitonin（PCT）in the three groups of children postoperatively were observed. The onset of postoperative complications was also observed. Results After operation，the PaO2 levels of the three groups increased compared to pre-operation（P<0.05），and the PaO2 level of the negative pressure suction group was（83.75±6.37）mmHg，which was higher than that of the biopsy forceps removal group（78.34±6.16）mmHg and the brush removal group（79.51 ± 5.96）mmHg，respectively（P<0.05）；the PaCO2 levels of the three groups decreased compared to pre -operation（P<0.05），and the PaCO2 level of the negative pressure suction group was（44.15 ± 3.12） mmHg，which was lower than that of biopsy forceps removal group（46.56±4.98）mmHg（P<0.05）. The levels ofTNF-α, IL - 6，IL - 1β and PCT in all three groups decreased compared to pre -operation（P<0.05），and the negative pressure suction group was lower among the three groups（P<0.05）. For mechanical operation-related complications，only the incidence of mucosal injury differed significantly among the three groups(χ2=7.891，P=0.019），with the negative pressure suction group lower than the brush removal group（8.00% vs 30.00%，χ2=7.861，P<0.017）；differences in other complications among the three groups were not statistically significant（P>0.05）. Conclusion Negative pressure suction in the treatment of PB in children has the least impact on blood oxygen and the lightest inflammatory reaction， with fewer complications，and it can be used as the preferred choice for removing plastic casts in children with PB.
keywords: Plastic bronchitis Bronchial plastic casts Bronchoscopy Negative pressure suction Oxygen status Inflammatory factors
文章编号： 中图分类号：R725.6 文献标志码：A
基金项目:徐州市卫生健康委员会科技项目（XWKYHT20220072）
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