无创高频振荡通气联合布地奈德雾化吸入治疗新生儿重症肺炎的临床疗效

Clinical Efficacy of High Frequency Oscillatory Ventilation Combined with Budesonide Atomization Inhalation in the Treatment of Neonatal Severe Pneumonia

【目的】探讨无创高频振荡通气联合布地奈德雾化吸入治疗新生儿重症肺炎的临床疗效。【方法】选取2016年9月至2021年6月本院收治的81例新生儿重症肺炎患儿,根据随机数字表法将其分为观察组(n=41)和对照组(n=40)。对照组在基础治疗的基础上给予无创高频振荡通气治疗,观察组在对照组的基础上联合布地奈德雾化吸入治疗。记录两组患儿治疗后肺部湿啰音、咳嗽、发热、气喘等症状消失时间及无创高频振荡通气时间,比较两组患儿治疗前、治疗10 d后肺功能指标[呼吸峰流速(PEF)、达峰容积比(VPEF/VE)及达峰时间比(TPTEF/TE)]及血液学指标[Clara细胞蛋白16(CC16)、Ⅱ型肺泡表面抗原6(KL-6)],记录两组患儿治疗期间不良反应发生情况。【结果】观察组患儿湿啰音消失时间、咳嗽消失时间、气喘消失时间、发热消失时间均短于对照组,观察组患儿无创高频振荡通气时间短于对照组,差异有统计学意义(P<0.05)。治疗后,两组患儿TPTEF/TE、PEF、VPEF/VE水平均高于治疗前,且观察组均高于对照组,差异有统计学意义(P<0.05);两组患儿的血清KL-6、CC16水平较治疗前均降低,且观察组均低于对照组,差异有统计学意义(P<0.05)。两组患儿不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】无创高频振荡通气联合布地奈德雾化吸入治疗可有效缩短重症肺炎患儿临床症状改善时间及无创高频振荡通气时间,改善患儿的肺功能,并降低血清KL-6、CC16水平,且安全性良好。

【Objective】To investigate the clinical effect of high frequency oscillatory ventilation combined with budesonide atomization inhalation in the treatment of neonatal severe pneumonia.【Methods】A total of 81 cases of neonatal severe pneumonia in our hospital from September 2016 to June 2021 were selected and randomly divided into observation group(n=41)and control group(n=40).The control group was treated with high-frequency oscillatory ventilation on the basis of basic treatment,and the observation group was treated with budesonide atomization inhalation on the basis of the control group.The disappearance time of pulmonary wet rales,cough,fever,asthma and other symptoms and the time of high-frequency oscillatory ventilation were recorded in the two groups after treatment.The pulmonary function indexes[peak expiratory flow rate(PEF),peak volume ratio(VPEF/VE),and peak time ratio(TPTEF/TE)]and hematological indexes[serum Clara cell protein 16(CC16),typeⅡalveolar surface antigen 6(KL-6)]before and 10 days after treatment were compared between the two groups.The occurrence of adverse reactions during treatment was recorded.【Results】The disappearance time of wet rales,cough,asthma and fever in the observation group were shorter than those in the control group,and the high-frequency oscillation ventilation time in the observation group was shorter than that in the control group,with statistical significance(P<0.05).After treatment,the levels of TPTEF/TE,PEF and VPEF/VE in the two groups were higher than those before treatment,and those in the observation group were higher than those in the control group,with statistical significance(P<0.05);The serum levels of KL-6 and CC16 in the two groups were lower than those before treatment,and the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).【Conclusion】High frequency oscillatory ventilation combined with budesonide atomization inhalation therapy can effectively shorten the time of clinical symptoms improvement and high frequency oscillatory ventilation in children with severe pneumonia,improve the lung function of children,and reduce the serum levels of KL-6 and CC16,with good safety.