支气管镜肺泡灌洗联合乙酰半胱氨酸治疗新生儿重症肺炎的疗效分析

Analysis of the efficacy of bronchoalveolar lavage combined with acetylcysteine in the treatment of severe neonatal pneumonia

目的分析支气管镜肺泡灌洗(BAL)联合乙酰半胱氨酸治疗新生儿重症肺炎的疗效。方法选取2019年3月至2023年3月该院收治的82例新生儿重症肺炎患儿作为研究对象,采用随机数字表法分为研究组和对照组,每组41例。对照组采用BAL治疗,研究组采用BAL联合乙酰半胱氨酸治疗。比较两组临床疗效、治疗前后症状消失时间、住院时间、治疗前后气道峰压(PIP)、肺顺应性(Cst)、气道阻力(Raw)、血清炎症免疫指标[白细胞介素(IL)-4、免疫球蛋白(Ig)G、IL-6、IgA]、不良反应发生情况。结果研究组临床总有效率(87.80%)高于对照组(68.29%),差异有统计学意义(χ^(2)=4.555,P=0.032)。研究组治疗后咳嗽、发热、肺部湿啰音等症状消失时间及住院时间均短于对照组,Raw、PIP、IL-6、IL-4均低于对照组,Cst、IgG、IgA均高于对照组,差异均有统计学意义(P<0.05)。研究组不良反应总发生率(17.08%)与对照组(19.52%)比较,差异无统计学意义(χ^(2)=0.081,P=0.775)。结论BAL联合乙酰半胱氨酸治疗方案疗效确切,可有效改善肺功能、疏通气道,降低炎症因子表达水平,增强呼吸道免疫功能,促进病情转归。

Objective To analyze the efficacy of bronchoalveolar lavage(BAL)combined with acetylcysteine in the treatment of severe neonatal pneumonia.Methods A total of 82 neonates with severe pneumonia admitted to the hospital from March 2019 to March 2023 were selected as the research objects,and they were divided into study group and control group by random number table method,with 41 cases in each group.The control group was treated with BAL,and the study group was treated with BAL combined with acetylcysteine.The clinical efficacy,symptom disappearance time before and after treatment,length of hospital stay,peak airway pressure(PIP),lung compliance(Cst),airway resistance(Raw),serum inflammatory immune indicators[interleukin(IL)-4,immune protein(Ig)G,IL-6,IgA],and adverse reactions were compared between the 2 groups.Results The total effective rate of study group(87.80%)was higher than that of control group(68.29%),and the difference was statistically significant(χ^(2)=4.555,P=0.032).After treatment,the disappearance time of cough,fever,lung moist rales and other symptoms and the length of hospital stay in study group were shorter than those in control group,while the Raw,PIP,IL-6 and IL-4 were lower than those in control group,Cst,IgG and IgA were higher than those in control group,and the differences were statistically significant(P<0.05).Study group at the incidence of adverse reactions to the total(17.08%)compared with control group(19.52%),there was no statistically significant difference(χ^(2)=0.081,P=0.775).Conclusion BAL combined with acetylcysteine treatment is effective,which can effectively improve lung function,clear airway,reduce the expression of inflammatory factors,enhance respiratory immune function,and promote the outcome of the disease.