雾化吸入布地奈德联合静脉氢化可的松治疗小儿重症喘憋性肺炎的疗效及痊愈率评价

Evaluation on Efficacy of Nebulized Budesonide Combined with Intravenous hydrocortisone in the Treatment of Severe Asthmatic Pneumonia in Children, and Cure Rate of the Disease

目的:探讨雾化吸入布地奈德联合静脉氢化可的松治疗小儿重症喘憋性肺炎的疗效和安全性。方法:选择2016年1月—2018年11月我院收治的134例重症喘憋性肺炎患儿为研究对象,采用随机数字表法分为A组和B组,各67例。A组在常规处理的基础上给予布地奈德(0.5 mg,bid,雾化吸入)治疗,B组在A组基础上给予氢化可的松(5~10 mg/kg,qd)静滴。比较两组患儿临床症状缓解时间、住院时间、临床疗效和不良反应,观察两组患儿治疗前后肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6、C反应蛋白(CRP)和降钙素原(PCT)水平。结果:B组喘憋、呼吸困难、啰音消失时间及住院时间均短于A组,差异有统计学意义(P<0.05);治疗后两组TNF-α、IL-6、CRP、PCT水平低于治疗前,且B组低于A组,差异有统计学意义(P<0.05);B组临床有效率高于A组,差异有统计学意义(P<0.05);两组患儿治疗过程中均未出现白细胞、血小板异常升高及肝肾功能损害。结论:氢化可的松联合布地奈德治疗重度喘憋性肺炎的临床疗效显著,可抑制气道炎症反应,缩短症状缓解时间,减少住院时间,安全性良好。

Objective:To explore the efficacy and safety of nebulized budesonide combined with intravenous hydrocortisone in the treatment of severe asthmatic pneumonia in children.Methods:134 children with severe asthmatic pneumonia admitted to our hospital from January 2016 to November 2018 were selected as subjects investigated,and they were randomly divided into group A and group B,67 cases each.The children in the group A were treated with budesonide(0.5 mg,bid,nebulized inhalation)on the basis of conventional treatment,and the children in the group B were treated with hydrocortisone(5~10 mg/kg,qd)by intravenous drip on the basis of the treatment in the group A.The remission time of clinical symptoms,hospitalization time,clinical efficacy and adverse reactions were compared between the two groups.The levels of tumor necrosis factor(TNF)-α,interleukin(IL)-6,C-reactive protein(CRP)and procalcitonin(PCT)before and after treatment in the two group were observed.Results:The disappearance time of wheezing,dyspnea and rales and hospitalization time in the group B was shorter than that in the group A,and the difference was statistically significant(P<0.05).The levels of TNF-α,IL-6,CRP and PCT after treatment were lower than those before treatment in the two groups,and the differences were statistically significant(P<0.05).The clinical effective rate in the group B was higher than that in the group A,and the difference was statistically significant(P<0.05).There was no abnormal increase of leukocytes and platelets and liver and kidney function damage in the two groups.Conclusion:Hydrocortisone combined with budesonide has a significant clinical effect in the treatment of severe asthmatic pneumonia,which can inhibit airway inflammation,shorten the remission time of symptoms and reduce hospitalization time,and has good safety.