乙酰半胱氨酸肺泡灌洗联合布地奈德治疗儿童重症肺炎支原体肺炎疗效观察

Clinical Observation of Acetylcysteine Alveolar Lavage Combined with Budesonide in the Treatment of Severe Mycoplasma Pneumonia in Children

目的 探讨吸入性乙酰半胱氨酸肺泡灌洗联合布地奈德局部用药在儿童重症肺炎支原体肺炎(MPP)患儿中的治疗效果。方法 选取2021年3月至2022年3月本院收治的88例重症MPP患儿,以随机数字表法分为对照组44例与观察组44例。对照组给予吸入性乙酰半胱氨酸肺泡灌洗治疗,观察组在对照组基础上予以布地奈德局部用药。持续观察至患儿出院。对比两组临床疗效、症状改善时间、炎症指标及不良反应发生率。结果 观察组治疗总有效率(95.45%)高于对照组(81.82%),咳嗽、发热、湿口罗音等改善时间短于对照组,有统计学差异(P<0.05);治疗72 h后,观察组白介素-17(IL-17)、C反应蛋白(CRP)、降钙素原(PCT)水平低于对照组,有统计学差异(P<0.05);两组不良反应发生率相比无统计学差异(P>0.05)。结论 吸入性乙酰半胱氨酸肺泡灌洗联合布地奈德局部用药可增强重症MPP治疗效果,减轻炎症反应,加快症状消退,不良反应少。

Objective To investigate the therapeutic effect of inhalation acetylcysteine alveolar lavage combined with budesonide in children with severe mycoplasma pneumoniae pneumonia(MPP).Methods 88 patients with severe MPP admitted to our hospital from March 2021 to March 2022 were randomly divided into control group(n=44)and observation group(n=44).The control group was treated with inhalation acetylcysteine alveolar lavage,and the observation group was treated with budesonide on the basis of the control group.Continue to observe until the child is discharged.The clinical efficacy,symptom improvement time,inflammatory index and adverse reaction rate of the two groups were compared.Results The total effective rate of the observation group(95.45%)was higher than that of the control group(81.82%),and the improvement time of cough,fever and moist rales was shorter than that of the control group(P<0.05);After 72 hours of treatment,the levels of interleukin-17(IL-17),C-reactive protein(CRP)and procalcitonin(PCT)in the observation group were lower than those in the control group(P<0.05);There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Inhaled acetylcysteine alveolar lavage combined with budesonide can enhance the therapeutic effect of severe MPP,reduce inflammatory reaction,accelerate the regression of symptoms,and have fewer adverse reactions.