氨溴索联合布地奈德混悬液雾化吸入治疗新生儿肺炎疗效观察

Curative effect of ambroxol combined with budesonide suspension in the treatment of neonatal pneumonia

目的观察氨溴索联合布地奈德混悬液雾化吸入治疗新生儿肺炎的疗效,并探讨其对患儿降钙素原(PCT)和C反应蛋白(CRP)的影响。方法选择2016年10月至2019年10月于深圳市宝安区石岩人民医院治疗的60例新生儿肺炎患者作为研究对象,按随机数表法均分为观察组和对照组各30例。两组患儿均采用常规对症治疗措施,对照组在此基础上采用单纯氨溴索治疗,观察组则采用氨溴索联合布地奈德混悬液雾化吸入治疗。治疗一周后比较两组患儿的临床疗效、PCT、CRP水平、肺功能指标、血气分析指标及症状消失时间。结果观察组患者的临床治疗总有效率为90.00%,明显高于对照组的66.67%,差异有统计学意义(P<0.05);治疗后,两组患儿的PCT、CRP水平均明显下降,且观察组PCT、CRP水平分别为(51.25±9.67) mg/L、(0.64±0.32) ng/mL,明显低于对照组的(78.13±10.03) mg/L、(1.06±0.46) ng/mL,差异均有统计学意义(P<0.05);治疗后,观察组患儿的达峰时间比(TPEF/TE)、达峰容积比(VPEF/VE)分别为(37.23±5.35)%、(34.54±4.52)%,明显高于对照组的(31.26±5.24)%、(27.88±4.05)%,且呼气峰流速(PEE)为(41.58±7.09) L/min,明显低于对照组的(49.07±6.05) L/min,差异均有统计学意义(P<0.05);治疗后,观察组动脉血氧分压(PaO2)、氧合指数(PaO2/FiO2)分别为(95.65±6.83) mmHg、(338.65±16.55) mmHg,明显高于对照组的(80.74±5.66) mmHg、(227.59±15.63) mmHg,动脉二氧化碳分压(PaCO2)为(37.56±4.06) mmHg,明显低于对照组的(41.85±4.41) mmHg,差异均有统计学意义(P<0.05);治疗后,观察组患儿的咳嗽、肺部啰音、气喘、鼻阻消失时间明显快于对照组,差异均有统计学意义(P<0.05)。结论氨溴索联合布地奈德混悬液雾化吸入治疗新生儿肺炎能降低患儿的炎症因子水平,改善肺功能,缩短症状消失时间,疗效显著,值得推广。

Objective To observe the efficacy of ambroxol combined with budesonide suspension in the treatment of neonatal pneumonia, and to explore its effect on procalcitonin(PCT) and C-reactive protein(CRP) in children.Methods A total of 60 cases of neonatal pneumonia patients, who admitted to Shiyan People’s Hospital of Bao’an District, Shenzhen from October 2016 to October 2019, were selected and divided into the observation group(n=30) and the control group(n=30) according to random number table method. Both groups were treated with conventional symptomatic treatment measures;the control group was treated with conventional treatment plus ambroxol atomization inhalation, and the observation group was treated with budesonide suspension atomization inhalation on the basis of the control group. Clinical efficacy, PCT, CRP level, lung function index, blood gas analysis index and symptom disappearance time of the two groups were compared one week after treatment. Results After treatment, the total clinical effective rate of the observation group was 90.00%, which was significantly higher than 66.67% of the control group(P<0.05);the levels of PCT and CRP in both groups were significantly decreased, and the levels of PCT and CRP in the observation group were(51.25 ± 9.67) mg/L and(0.64 ± 0.32) ng/mL, which were significantly lower than corresponding(78.13 ± 10.03) mg/L and(1.06 ± 0.46) ng/mL in the control group(P<0.05);the peak time ratio(TPEF/TE)and peak volume ratio(VPEF/VE) in the observation group were(37.23±5.35)% and(34.54±4.52)%, which were significantly higher than corresponding(31.26±5.24)% and(27.88±4.05)% in the control group, and the peak expiratory flow rate(PEE) was(41.58±7.09) L/min versus(49.07±6.05) L/min in the control group(all P<0.05);the levels of arterial partial blood oxygen pressure(PaO2) and oxygenation index(PaO2/FiO2) in the observation group were(95.65 ±6.83) mmHg and(338.65±16.55) mmHg, which were significantly higher than corresponding(80.74±5.66) mmHg and(227.59 ± 15.63) mmHg in the control group, and the levels of arterial carbon dioxide partial pressure(PaCO2) was(37.56±4.06) mmHg versus(41.85±4.41) mmHg in the control group(all P<0.05);the disappearance time of cough,lung rales, asthma and nasal obstruction in the observation group were significantly faster than those in the control group(all P<0.05). Conclusion The efficacy of ambroxol combined with budesonide suspension aerosol inhalation on neonatal pneumonia is significant, which can reduce the level of inflammatory factors, improve lung function and shorten the symptom disappearance time.