氨溴索联合头孢哌酮钠舒巴坦钠治疗新生儿感染性肺炎的临床效果

Clinical effect of ambroxol combined with cefoperazone sodium and sulbactam sodium in the treatment of neonatal infectious pneumonia

目的 观察氨溴索联合头孢哌酮钠舒巴坦钠治疗新生儿感染性肺炎(NIP)的临床效果。方法 选取2017年1月—2019年1月山东省德州市人民医院新生儿医学科收治的NIP患儿182例,根据随机数字表法分为试验组和对照组,每组91例。试验组患儿给予氨溴索联合头孢哌酮钠舒巴坦钠治疗,对照组患儿给予头孢哌酮钠舒巴坦钠治疗,2组均连续治疗7 d。比较2组患儿治疗效果、治疗前后血清学指标[C反应蛋白(CRP)、降钙素原(PCT)]、血气分析指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、氧合指数(OI)]、临床症状(肺部啰音、咳嗽、呼吸急促及紫绀)持续时间及不良反应。结果 试验组患儿的治疗总有效率为91.21%(83/91),高于对照组的79.12%(72/91)(χ^(2)=5.262,P=0.022);治疗7 d后,2组患儿CRP、PCT、PaCO_(2)水平均较治疗前下降,PaO_(2)、OI水平均较治疗前上升,且试验组变化幅度大于对照组(P<0.01);试验组患儿肺部啰音、咳嗽、呼吸急促、紫绀持续时间短于对照组(P<0.05);试验组患儿药物不良反应总发生率为23.08%(21/91),对照组患儿药物不良反应总发生率为20.88%(19/91),2组比较差异无统计学意义(χ^(2)=0.128,P=0.720)。结论 在常规治疗方法的基础上,采用氨溴索雾化吸入联合头孢哌酮钠舒巴坦钠治疗NIP的效果较好,可改善血清学指标及血气分析指标,缩短患儿症状持续时间,且安全可靠,值得临床推广应用。

Objective To observe the clinical effect of ambroxol combined with cefoperazone sodium and sulbactam sodium in the treatment of neonatal infectious pneumonia(NIP). Methods From January 2017 to January 2019, 182 children with NIP admitted to the Department of Neonatal Medicine of Dezhou People′s Hospital of Shandong Province were selected. According to the random number method, they were divided into experimental group and control group, with 91 cases in each group. The children in the experimental group were treated with ambroxol combined with cefoperazone sodium and sulbactam sodium, and the children in the control group were treated with cefoperazone sodium and sulbactam sodium, both groups were treated for 7 days. The treatment effect, serological indexes[C-reactive protein(CRP), procalcitonin(PCT)], blood gas analysis indexes[arterial partial pressure of oxygen(PaO_(2)), arterial partial pressure of carbon dioxide(PaCO_(2)), oxygenation index(OI)] before and after treatment, clinical symptoms duration(pulmonary rales, cough, tachypnea and cyanosis) and adverse reactions were compared between the two groups. Results The total effective rate of children in the experimental group was 91.21%(83/91), which was higher than 79.12%(72/91) in the control group(χ^(2)=5.262, P=0.022);After 7 days of treatment, the levels of CRP, PCT and PaCO_(2)in the two groups were decreased compared with those before treatment, and the levels of PaO_(2)and OI were increased compared with those before treatment, and the changes in the experimental group were greater than those in the control group(P<0.01);The duration of lung rales, cough, shortness of breath and cyanosis in the experimental group was shorter than that in the control group(P<0.05);The total incidence of adverse drug reactions was 23.08%(21/91) in the experimental group and 20.88%(19/91) in the control group, and there was no significant difference between the two groups(χ^(2)=0.128, P=0.720). Conclusion On the basis of conventional treatment methods, the use of ambroxol aerosol inhalation combined with cefoperazone sodium sulbactam sodium in the treatment of NIP is effective, can improve serological indicators and blood gas analysis indicators, shorten the duration of symptoms in children, and is safe and reliable, worthy of clinical application.