支气管镜肺泡灌洗术联合乙酰半胱氨酸与盐酸氨溴索治疗新生儿重症肺炎的效果研究

Effect of Bronchoscopic Alveolar Lavage Combined with Acetylcysteine and Ambroxol Hydrochloride in Severe Neonatal Pneumonia

目的:分析支气管镜肺泡灌洗术联合乙酰半胱氨酸与盐酸氨溴索治疗新生儿重症肺炎的临床效果。方法:选取2016年12月—2019年6月杞县人民医院收治的124例重症肺炎新生儿患者作为研究对象,随机分为对照组及研究组,每组各62例,对照组单独行支气管镜肺泡灌洗术,研究组在对照组的基础上应用乙酰半胱氨酸与盐酸氨溴索。统计并比较两组患儿的临床疗效及相关临床指标,检测并比较两组患儿治疗前后血清细胞因子及血气指标水平。结果:与对照组相比,研究组肺部啰鸣音消失时间、入住ICU时间、呼吸困难缓解时间、心率恢复正常时间、抗生素使用时间均显著短于对照组,差异有统计学意义(t=2.542、3.594、3.228、3.330、4.551,P<0.05)。与治疗前比较,治疗后两组患儿血清中IL-2、IL-6、IL-10水平均显著下降,且治疗后研究组上述指标水平均显著低于对照组,差异有统计学意义(t=3.353、3.090、2.812,P<0.05)。与治疗前比较,治疗后两组患儿PaO_(2)水平均显著升高,且治疗后研究组PaO_(2)水平显著高于对照组,差异有统计学意义(t=4.055,P<0.05)。与治疗前比较,治疗后两组患儿PaCO_(2)及血乳酸水平均显著下降,且治疗后研究组PaCO_(2)及血乳酸水平显著低于对照组,差异有统计学意义(t=4.197、2.696,P<0.05)。结论:在支气管镜肺泡灌洗术中应用乙酰半胱氨酸与盐酸氨溴索治疗新生儿重症肺炎可更加有效缓解患儿临床症状,抑制炎症进展,改善其血气指标,值得临床推广应用。

Objective:To analyze the clinical effect of bronchoalveolar lavage combined with acetylcysteine and ambroxol hydrochloride in the treatment of severe neonatal pneumonia.Methods:A total of 124 neonatal patients with severe pneumonia who were admitted to the hospital from December 2016 to June 2019 were selected as the research objects,and randomly divided into control group of 62 cases and research group of 62 cases.The children in the control group were treated with bronchoscopic bronchoalveolar lavage alone,and the patients in the study group were treated with acetylcysteine and ambroxol hydrochloride on the basis of the control group.The clinical efficacy and related clinical indicators of the two groups of children were statistically and compared.The levels of serum cytokines and blood gas indexes were detected and compared between the two groups before and after treatment.Results:Compared with the control group,the disappearance time of pulmonary rales,the time of ICU stay,the time to relieve dyspnea,the time for heart rate to return to normal,and the time for antibiotic use in the study group were significantly shorter than those in the control group,and the differences were statistically significant(t=2.542,3.594,3.228,3.330,4.551,P<0.05).Compared with before treatment,the serum levels of IL-2,IL-6,and IL-10 in the two groups of children after treatment were significantly decreased,and the levels of the above indicators in the study group were significantly lower than those in the control group after treatment,and the difference was statistically significant(t=3.353,3.090,2.812,P<0.05).Compared with before treatment,the PaO_(2) levels of the two groups of children were significantly increased after treatment,and the PaO_(2) levels of the children in the study group were significantly higher than those in the control group after treatment,and the difference was statistically significant(t=4.055,P<0.05).Compared with before treatment,the levels of PaCO_(2) and blood lactate in the two groups were significantly decreased after treatment,and the levels of PaCO_(2)and blood lactate in the study group were significantly lower than those in the control group after treatment,the difference was statistically significant(t=4.197,2.696,P<0.05).Conclusion:The application of acetylcysteine and ambroxol hydrochloride in the treatment of severe neonatal pneumonia during bronchoscopic bronchoalveolar lavage can more effectively relieve the clinical symptoms of children,inhibit the progression of inflammation,and improve their blood gas indicators,which is worthy of clinical application.