头孢曲松+小剂量糖皮质激素联合肺泡灌洗术治疗儿童大叶性肺炎疗效分析

Effect of Ceftriaxone Plus Low Dose Glucocorticoid Combined with Alveolar Lavage on Lobar Pneumonia in Children

目的:探讨头孢曲松+小剂量糖皮质激素联合肺泡灌洗术对儿童大叶性肺炎的治疗效果。方法:选取我院2019年10月到2022年10月收治的270例大叶性肺炎儿童作为研究对象,依据治疗方法将患儿分为A、B、C三组,每组90例。所有患儿均采取常规维持水电解质、酸碱平衡、吸痰、清热、平喘、止咳等治疗,A组患儿在常规治疗基础上应用头孢曲松治疗,B组应用头孢曲松+小剂量糖皮质激素治疗,C组应用头孢曲松+小剂量糖皮质激素联合肺泡灌洗术治疗,对比三组患儿体征消失时间、影像学恢复时间,治疗前后白细胞计数(WBC)、中性粒细胞百分比(GRA)、降钙素原(PCT)、C反应蛋白(CRP)、血沉(ESR)表达水平,临床疗效以及不良反应发生率。结果:三组患儿肺啰音/哮鸣音消失时间、咳嗽消失时间、发热总天数、影像学恢复时间对比差异显著,且C组明显低于B组和A组(P<0.05);三组患儿治疗前WBC、GRA、PCT、CRP、ESR表达水平对比无明显差异(P>0.05),治疗后三组患儿WBC、GRA、PCT、CRP、ESR表达水平均降低,且C组明显低于B组和A组(P<0.05);三组患儿治疗效果对比差异显著,C组明显高于B组和A组(P<0.05);三组患儿不良反应发生率对比无明显差异(P>0.05)。结论:采用头孢曲松+小剂量糖皮质激素联合肺泡灌洗术治疗儿童大叶性肺炎能够快速减轻患儿临床症状,降低炎症因子反应,提升治疗效果,且安全性较高,能够让患儿早日康复出院。

Objective:To investigate the therapeutic effect of ceftriaxone plus low dose glucocorticoid combined with alveolar lavage on lobar pneumonia in children.Methods:270 children with lobar pneumonia admitted in our hospital from October 2019 to October 2022 were selected as the research objects.The children were divided into three groups:A,B and C,with 90 cases in each group according to the treatment methods.All children were treated with routine maintenance of water and electrolyte,acid-base balance,sputum aspiration,heat clearing,asthma relieving,cough relieving,etc.Group A children were treated with ceftriaxone on the basis of routine treatment,Group B with ceftriaxone+low-dose glucocorticoid,and Group C with ceftriaxone+low-dose glucocorticoid combined with alveolar lavage.The disappearance time of signs,imaging recovery time of the three groups were compared,The expression levels of white blood cell count(WBC),neutrophil percentage(GRA),procalcitonin(PCT),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),clinical efficacy and adverse reaction rate before and after treatment.Results:There were differences in the disappearance time of lung rale/wheeze,cough,total days of fever,imaging recovery time among the three groups,and group C was lower than group B and group A(P<0.05);There was no difference in the expression levels of WBC,GRA,PCT,CRP,and ESR among the three groups before treatment(P>0.05).After treatment,the expression levels of WBC,GRA,PCT,CRP,and ESR in the three groups decreased,and group C was lower than group B and group A(P<0.05);The therapeutic effects of the three groups were different.Group C was higher than group B and group A(P<0.05);There was no significant difference in the incidence of adverse reactions among the three groups(P<0.05).Conclusion:Ceftriaxone+low-dose glucocorticoid combined with alveolar lavage can rapidly reduce the clinical symptoms of children with lobar pneumonia,reduce the inflammatory factor response,improve the treatment effect,and has high safety,which can enable children to recover and leave hospital as soon as possible.