摘要
目的探析小儿重症肺炎患儿在接受支气管镜肺泡灌洗术中局部注入乙酰半胱氨酸结合布地奈德的有效性。方法回顾性分析68例行支气管镜肺泡灌洗术的重症肺炎患儿的临床资料,根据治疗方式的不同划分为参比组和观察组,各34例。参比组在常规治疗基础上行支气管镜肺泡灌洗术治疗,观察组在参比组治疗基础上局部注入乙酰半胱氨酸、布地奈德治疗。对比两组治疗效果、症状恢复情况、炎症指标、并发症发生率。结果观察组治疗总有效率(97.06%)高于参比组(82.35%)(P<0.05)。观察组体温恢复正常时间、咳嗽消失时间、肺部啰音消失时间、影像学恢复正常时间、住院时间分别为(4.10±1.26)、(8.90±1.33)、(8.06±1.15)、(10.84±1.35)、(12.05±1.45)d,均短于参比组的(5.65±1.85)、(10.83±2.35)、(10.25±2.13)、(12.65±2.23)、(14.76±2.54)d(P<0.05)。两组治疗前的白细胞介素-6、降钙素原、C反应蛋白对比差异无统计学意义(P>0.05)。治疗后,两组的白细胞介素-6、降钙素原、C反应蛋白均低于本组治疗前,且观察组的白细胞介素-6(10.22±2.62)pg/ml、降钙素原(0.48±0.15)ng/ml、C反应蛋白(6.11±2.12)mg/L低于参比组的(15.56±2.35)pg/ml、(0.75±0.17)ng/ml、(13.35±2.42)mg/L(P<0.05)。治疗期间,两组并发症发生率对比,观察组(5.88%)较参比组(8.82%)略低,但差异无统计学意义(P>0.05)。结论小儿重症肺炎支气管镜肺泡灌洗术中局部注入乙酰半胱氨酸、布地奈德的疗效突出,可以促进患儿临床症状恢复,减轻炎症反应,缩短住院时间,且并不增加治疗期间并发症,安全性较好,值得借鉴。
Objective To explore the effectiveness of local injection of acetylcysteine and budesonide during bronchoscopic alveolar lavage for children with severe pneumonia.Methods The clinical data of 68 children with severe pneumonia who underwent bronchoscopic alveolar lavage were retrospectively analyzed,and they were divided into a reference group and an observation group according to the different treatment modalities,each with 34 cases.The reference group was treated with bronchoscopic alveolar lavage on the basis of conventional therapy,and the observation group was treated with local injection of acetylcysteine and budesonide on the basis of the reference group.The therapeutic effect,symptom recovery,inflammation index,and complication rate of the two groups were compared.Results The total effective rate of the observation group(97.06%)was higher than that of the reference group(82.35%)(P<0.05).In the observation group,the time for recovery of body temperature,time for disappearance of cough,time for disappearance of lung rales,time for recovery of imaging,and hospitalization time were(4.10±1.26),(8.90±1.33),(8.06±1.15),(10.84±1.35),and(12.05±1.45)d,which were shorter than(5.65±1.85),(10.83±2.35),(10.25±2.13),(12.65±2.23),and(14.76±2.54)d in the reference group(P<0.05).Before treatment,there was no significant difference in the levels of interleukin-6,procalcitonin and C-reactive protein between the two groups(P>0.05).After treatment,the levels of interleukin-6,procalcitonin and C-reactive protein in both groups were lower than those before treatment;the observation group had interleukin-6 of(10.22±2.62)pg/ml,procalcitonin of(0.48±0.15)ng/ml,and C-reactive protein of(6.11±2.12)mg/L,which were lower than(15.56±2.35)pg/ml,(0.75±0.17)ng/ml,and(13.35±2.42)mg/L in the reference group(P<0.05).During treatment,the complication rate of the observation group(5.88%)was slightly lower than that of the reference group(8.82%),but the difference was not statistically significant(P>0.05).Conclusion Local injection of acetylcysteine and budesonide during bronchoscopic alveolar lavage in children with severe pneumonia has outstanding curative effect,which can promote the recovery of clinical symptoms in children,reduce inflammation,shorten the hospitalization time without increasing complications during treatment,and has good safety,which is worthy of reference.
作者
杨元琴
玉珍
关居山
次仁公布
YANG Yuan-qin;YU Zhen;GUAN Ju-shan(Department of Pediatrics,Lhasa People's Hospital,Lhasa 850000,China)
出处
《中国实用医药》
2025年第10期17-20,共4页
China Practical Medicine
基金
西藏自治区拉萨市科技计划项目(项目编号:LSKJ202204)。
