【摘要】 目的 儿童难治性肺炎支原体肺炎(RMPP)治疗难度较大，为提高患儿预后水平，探讨纤维支气管镜肺泡灌洗治疗儿童RMPP的临床效果。方法 选取2020年6月—2024年6月长兴县人民医院收治的90例RMPP患儿为研究对象，采用随机数表法将患儿分为对照组(45例)和观察组(45例)。2组基本治疗方法相同，观察组增加纤维支气管镜肺泡灌洗治疗。评价2组RMPP临床疗效、临床症状改善情况、血清炎症标志物和肺损伤标志物水平，随访治疗结束后1个月内RMPP相关并发症情况。结果 观察组RMPP总体治疗有效率[97.78%(44/45)]高于对照组[82.22%(37/45),χ~2=4.444,P=0.035];观察组发热、咳嗽、肺部湿啰音等肺炎临床症状持续时间均短于对照组(P<0.001);观察组治疗后血清铁蛋白和乳酸脱氢酶水平均低于对照组；观察组治疗后血清TNF-α、hs-CRP、降钙素原、IL-6水平均低于对照组(P<0.001);观察组治疗结束后1个月内RMPP相关并发症总发生率[4.44%(2/45)]显著低于对照组[20.00%(9/45),P<0.05]。结论 纤维支气管镜肺泡灌洗可用于治疗儿童RMPP,通过清除气道炎症分泌物，减轻炎症反应和肺损伤，促进临床症状迅速改善，提高疗效。更多还原

【Abstract】 Objective The treatment of refractory Mycoplasma pneumoniae pneumonia(RMPP) in children is difficult. In order to improve the prognosis of children, this study explores the clinical effect of fiberoptic bronchoscopy bronchoalveolar lavage in the treatment of RMPP in children. Methods A total of 90 children with RMPP admitted to Changxing County People’s Hospital from June 2020 to June 2024 were selected as the research objects. The children were divided into the control group(45 cases) and the observation group(45 cases) by the random number table method. The two groups received the same basic treatment, with the observation group receiving treatment with fiberoptic bronchoscopy and bronchoalveolar lavage. The clinical efficacy, improvement of clinical symptoms, levels of serum inflammatory markers and lung injury markers of RMPP were evaluated, and RMPP related complications within one month after the end of treatment was followed up. Results The overall treatment efficacy rate of RMPP in the observation group [97.78%(44/45)] was significantly higher than that in the control group [82.22%(37/45), χ~2=4.444, P=0.035]. The duration of clinical symptoms such as fever, cough, and wet rales in the observation group were significantly shorter than those in the control group(P<0.001). The serum SF and LDH levels in the observation group after treatment were significantly lower than those in the control group. The serum levels of TNF-α, hs-CRP, PCT, and IL-6 in the observation group after treatment were significantly lower than those in the control group(P<0.001). The overall incidence of RMPP related complications within one month after treatment in the observation group [4.44%(2/45)] was significantly lower than that in the control group [20.00%(9/45), P<0.05]. Conclusion Fiberoptic bronchoscopy bronchoalveolar lavage is used to treat RMPP in children, by clearing airway inflammatory secretions, reducing inflammatory reactions and lung damage, promoting rapid improvement of clinical symptoms, and enhancing efficacy.更多还原