Clinical observation of bronchoscopy alveolar lavage combined with thoracoscopy in the treatment of empyema in children

The objective of this study was to investigate the therapeutic effects of bronchoscopy alveolar lavage (BAL) combined with thoracoscopy in the treatment of empyema in children. Retrospectively analyzed 174 cases of pediatric empyema treated with thoracoscopy combined with BAL from January 2010 to December 2016 in our hospital. All the cases, according to admission order, were randomly divided into 2 groups, the control group (group A), which contained 89 cases, was treated with thoracoscopy; and the experimental group (group B), which contained 85 cases, was treated with BAL combined with thoracoscopy. The results of BAL treatment, the inflammatory indexes including body temperature, total leukocyte count in peripheral blood and CRP, and the therapeutic effect and prognosis including the days of antibiotic use, hospital stay, the incidence of thoracotomy and lobectomy were compared between the 2 groups. 1. There was no significant difference in inflammatory indexes between the 2 groups: body temperature ((o)C), (39.06 ± 0.047 and 39.08 ± 0.050), P > .855; routine leukocyte count (∗10^9/L), (25.93 ± 1.035 and 24.76 ± 1.019), P > .425); C-reactive protein (mg/L), (128.7 ± 6.653 and 138.6 ± 7.53), P > .328. 2. The results of BAL: hyperemia and edema was detected in trachea intima of all cases, including 32 cases of purulent secretion and ulcer, 21 cases of lumen deformation and 5 cases of foreign body. 3. There were statistical significances in the curative effects of the control group and the experimental group: the duration of antibiotic use (days), (21.07 ± 0.342 and 17.07 ± 0.288), P < .0001); the average hospital stay (days), (22.91 ± 0.347 and 18.79 ± 0.287), P < .0001; secondary surgery (thoracotomy), 15 cases in the control group, 5 cases in the experimental group, P < .023; lung lobectomy (disability rate), 13 cases in the control group and 3 cases in the experimental group, P < .011. There was statistical difference in all the therapeutic indexes (P < .05). Bronchoscopy alveolar lavage combined with thoracoscopy has a higher success rate in the treatment of pediatric empyema, and is more comprehensive, safe and effective in controlling inflammation.