布地奈德联合氨溴索雾化吸入对新生儿胎粪吸入性肺炎细胞因子及肺功能的影响

Effect of Budesonide combined with atomization inhalation of Ambroxol on cytokines and lung function in neonatal meconium aspiration pneumonia

目的探讨布地奈德联合氨溴索雾化吸入对新生儿胎粪吸入性肺炎细胞因子及肺功能的影响。方法回顾性分析2019年6月至2020年6月在江西省瑞金市妇幼保健院新生儿科进行治疗的60例胎粪吸入性肺炎新生儿的临床资料,根据治疗方案的差异将其分成对照组与治疗组,每组各30例。对照组患儿实施常规治疗,治疗组患儿在常规方案的基础上加用布地奈德联合氨溴索雾化吸入方式治疗。比较两组患儿的住院时间、肺功能指标复常时间、肺部啰音消失时间、发绀消失时间、不良反应发生情况、病情控制总有效率、治疗前后的炎症因子和肺功能指标水平。结果治疗组患儿的住院时间、肺功能指标复常时间、肺部啰音消失时间、发绀消失时间短于对照组,差异有统计学意义(P<0.05)。治疗组患儿的不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。治疗组患儿的病情控制总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,治疗组患儿的动脉血二氧化碳分压、白细胞计数、C反应蛋白、白细胞介素6、白细胞介素10水平低于对照组,白细胞介素2和动脉血氧分压水平高于对照组,差异有统计学意义(P<0.05)。结论胎粪吸入性肺炎新生儿采用布地奈德联合氨溴索雾化吸入方式进行治疗,能够减少不良反应,缩短患儿住院时间、肺功能指标复常时间、肺部啰音消失时间、发绀消失时间,大幅度改善炎症因子和肺功能指标水平,使病情控制总有效率提高。

Objective To investigate the effect of Budesonide combined with atomization inhalation of Ambroxol on cytokines and lung function in neonatal meconium aspiration pneumonia.Methods The clinical data of 60 neonates with meconium aspiration pneumonia treated in the Department of Neonatology,Ruijin Maternal and Child Health Hospital of Jiangxi Province from June 2019 to June 2020 were retrospectively analyzed.According to the difference of treatment regimen,they were divided into control group and treatment group,with 30 cases in each group.The control group was treated with routine treatment,and the treatment group was treated with Budesonide combined with atomization inhalation of Ambroxol on the basis of routine regimen.The length of hospital stay,recovery time of lung function indexes,disappearance time of pulmonary rales,cyanosis disappearance time,occurrence of adverse reactions,total effective rate of disease control,inflammatory factors and lung function indexes before and after treatment were compared between the two groups.Results The length of hospital stay,recovery time of lung function indexes,disappearance time of pulmonary rales and cyanosis in the treatment group were shorter than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the treatment group was lower than that in the control group,and the difference was statistically significant(P<0.05).The total effective rate of disease control in the treatment group was higher than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of arterial partial pressure of carbon dioxide,white blood cell count,C-reactive protein,interleukin 6 and interleukin 10 in the treatment group were lower than those in the control group,while the levels of interleukin 2 and arterial partial pressure of oxygen were higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion Budesonide combined with atomization inhalation of Ambroxol in the treatment of meconium aspiration pneumonia can reduce the adverse reactions,shorten the hospitalization time,the normalization time of pulmonary function indexes,the disappearance time of pulmonary rales and cyanosis,greatly improve the levels of inflammatory factors and pulmonary function indexes,and improve the total effective rate of disease control.