乌司他丁联合机械通气对社区获得性肺炎重症患儿动脉血气指标和炎症因子的影响

Effects of ulinastatin combined with mechanical ventilation on arterial blood gas indexes and inflammatory factors in children with severe community-acquired pneumonia

目的研究乌司他丁联合机械通气对社区获得性肺炎(CAP)重症患儿动脉血气指标和炎症因子的影响。方法选取社区获得性肺炎重症患儿100例,将其均分为对照组和观察组,对照组采用常规治疗加机械通气,观察组在对照组基础上使用乌司他丁治疗。比较两组临床有效率、并发症、临床症状消退时间、治疗前后动脉血二氧化碳分压(PaCO_(2))、呼气末二氧化碳分压(PetCO_(2))、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平,并对CAP严重程度评估。结果与对照组比较,观察组总有效率明显升高,咳嗽、发热、呼吸困难、肺部湿性啰音消退时间缩短(P<0.05)。与治疗前比较,治疗后两组动脉血气指标及炎症因子水平明显下降,且观察组下降幅度明显大于对照组(P<0.05)。与治疗前比较,治疗后两组CAP严重程度均有所改善,且观察组改善情况明显优于对照组(P<0.05)。结论乌司他丁联合机械通气治疗CAP重症患儿能提高临床治疗有效率,改善血气指标,降低炎症因子水平,并发症发生率低,具有较高的临床应用价值。

Aim To study the effects of ulinastatin combined with mechanical ventilation on arterial blood gas indexes and inflammatory factors in severe children with community-acquired pneumonia(CAP).Methods 100 severe children with community-acquired pneumonia were selected and divided into control group and observation group.The control group was treated with routine treatment and mechanical ventilation,and the observation group was treated with ulinastatin on the basis of the control group.The clinical effective rate,complications,clinical symptom regression time,arterial blood carbon dioxide partial pressure(PaCO_(2)),end expiratory carbon dioxide partial pressure(PetCO_(2)),C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α)level before and after treatment were compared between the two groups and the severity of CAP was assessed.Results Compared with the control group,the total effective rate of the observation group was significantly higher,including cough,fever,dyspnea.The regression time of pulmonary wet rale was shortened(P<0.05).Compared with that before treatment,the arterial blood gas index and inflammatory factor level in the two groups decreased significantly after treatment,and the decline range in the observation group was significantly greater than that in the control group(P<0.05).Compared with that before treatment,the severity of CAP in the two groups improved after treatment,and the improvement in the observation group was significantly better than that in the control group(P<0.05).Conclusion Ulinastatin combined with mechanical ventilation in the treatment of severe children with CAP can improve the clinical treatment efficiency,improve blood gas indexes,reduce the level of inflammatory factors,reduce the incidence of complications,and has high clinical application value.