阿奇霉素、甲强龙及早期CPAP联合治疗对重症肺炎患儿症状、血气指标和全身炎症反应的影响

Effects of azithromycin, methylprednisolone and early CPAP combination therapy on symptoms, blood gas indexes and systemic inflammatory response in children with severe pneumonia

目的探讨阿奇霉素、甲强龙及早期持续气道正压通气(CPAP)联合治疗对重症肺炎(SP)患儿症状、血气指标和全身炎症反应的影响。方法选取2017年10月至2018年10月咸阳市中心医院儿科收治的106例SP患儿作为研究对象,采用完全随机数列表法将其分为对照组和观察组,每组53例。对照组给予阿奇霉素联合早期CPAP治疗,观察组在对照组基础上给予甲强龙治疗。比较两组的治疗效果。结果观察组主要症状消退时间及住院天数均明显短于对照组(P<0.05)。治疗后,两组PaO2、SaO2均显著升高,PaCO2显著下降,且观察组优于对照组(P<0.05)。治疗后,两组血清IL-8、IL-6、TNF-α水平显著下降,IL-10水平升高,且观察组优于对照组(P<0.05)。结论阿奇霉素、甲强龙及早期CPAP联合治疗SP效果显著,可有效促进患儿临床症状好转,调节血气指标,降低全身炎症反应。

Objective To investigate the effects of azithromycin, methylprednisolone and early continuous positive airway pressure(CPAP) combination therapy on the symptoms, blood gas indexes and systemic inflammatory response in children with severe pneumonia(SP). Methods A total of 106 children with SP admitted in the pediatrics department of Xianyang central hospital from October 2017 to October 2018 were selected as the study objects and divided into control group and observation group by completely random number list method, with 53 cases in each group. The control group was treated with azithromycin and early CPAP, and the observation group was treated with methylprednisolone on the basis of the control group. The therapeutic effects of the two groups were compared. Results The disappearing time of major symptoms and hospital stay in the observation group were significantly shorter than those in the control group(P<0.05). After treatment, PaO2 and SaO2 increased significantly, PaCO2 decreased significantly in the two groups, and those in the observation group were better than the control group(P<0.05). After treatment, the levels of serum IL-8, IL-6, TNF-α decreased significantly, IL-10 level increased in the two groups, and those in the observation group were better than the control group(P<0.05). Conclusion The combination of azithromycin, methylprednisolone and early CPAP on SP has significant curative effect, which can effectively improve the clinical symptoms, regulate blood gas indexes and reduce systemic inflammatory response of children.