Analysis of risk factors of multiple bronchoscopic lavage in children with lobar pneumonia
10.3760/cma.j.cn115455-20231227-00628
- VernacularTitle:大叶性肺炎患儿多次行支气管镜下灌洗的危险因素分析
- Author:
Yahong WANG
1
;
Youwei ZHANG
1
Author Information
1. 湖北医药学院附属人民医院儿科，十堰 442000
- Publication Type:Journal Article
- Keywords:
Lobar pneumonia;
Bronchoscopes;
Risk factors;
Propensity score matching
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(4):348-352
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the influencing factors of multiple bronchoscopic lavage in children with lobar pneumonia and evaluate its predictive value.Methods:The clinical data of 184 children with lobar pneumonia who underwent bronchoscopic lavage in the Hubei Medical College Affiliated People′s Hospital from September 2018 to June 2022 were retrospectively analyzed. According to the number of lavage, they were divided into the single lavage group (108 cases) and the multiple (≥ 2 times) lavage group (76 cases). The two groups was matched in a 1∶1 ratio by using propensity score matching (PSM), and the influencing factors for multiple lavage after matching was analyzed by multivariate Logistic regression analysis. The predictive effect of risk factors on multiple lavage was analyzed by the receiver operating characteristic (ROC) curve.Results:After PSM matching, a total of 68 pairs of children were successfully matched. According to multivariate Logistic regression analysis, the duration of preoperative fever ≥7 d, pleural effusion, procalcitonin (PCT) ≥2.0 μg/L, white blood cell (WBC) ≥12.0 × 10 9/L, C-reactive protein (CRP) ≥10.0 mg/L, neutrophil ratio (N%) ≥70%, lactate dehydrogenase (LDH) ≥300 U/L, erythrocyte sedimentation rate (ESR) ≥35.0 mm/1 h, serum alanine aminotransferase (ALT)>40 U/L, serum albumin (ALB)<35 g/L and mucus thrombus were risk factors for multiple bronchoscopic lavage in children with lobar pneumonia ( OR = 3.031, 2.230, 2.125, 3.050, 2.735, 3.043, 3.025, 3.360, 2.962, 2.989, 3.108, P<0.05). According to ROC curve analysis, the sensitivity and specificity of the combination of 11 influencing factors in predicting multiple bronchoscopic lavage in children with lobar pneumonia were 72.10% and 63.20% respectively, and the area under the curve was 0.733. Conclusions:The duration of preoperative fever, pleural effusion, PCT, WBC, CRP, N%, LDH, ESR, ALT, ALB and mucus thrombus are all influencing factors for multiple bronchoscopic lavage in children with lobar pneumonia, and comprehensive evaluation of the above influencing factors has predictive effect on multiple bronchoscopic lavage in children.
