氨溴索静脉滴注联合雾化吸入治疗新生儿肺炎的临床效果观察

Effect of intravenous drip combined with atomization inhalation of ambroxol in the treatment of neonatal pneumonia

目的评价氨溴索静脉滴注联合雾化吸入对新生儿肺炎治疗效果的影响。方法以72例新生儿肺炎患儿为研究对象,随机分为静脉滴注组(n=36)与联合组(n=36)。静脉滴注组在常规治疗基础上给予盐酸氨溴索静脉滴注,联合组在对照组基础上给予盐酸氨溴索雾化吸入。比较两组症状体征消退时间与住院时间,治疗前与治疗后3 d的血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]与炎症指标[血清C反应蛋白(CRP)、白细胞介素-6(IL-6)]水平,临床疗效。结果联合组发热、气促、咳嗽、肺部啰音消退时间及住院时间分别为(3.1±1.3)、(3.5±1.5)、(5.2±1.7)、(5.8±2.0)、(8.8±2.7)d,短于静脉滴注组的(3.9±1.5)、(4.5±1.8)、(6.3±2.3)、(7.1±2.6)、(10.6±3.1)d(P<0.05)。联合组治疗后3 d的PaO_(2)(76.0±9.1)mm Hg(1 mm Hg=0.133 kPa)高于静脉滴注组的(70.1±8.7)mm Hg,PaCO_(2)(45.1±4.3)mm Hg与血清CRP(19.4±8.6)mg/L、IL-6(141.6±51.7)ng/L显著低于静脉滴注组的(47.7±5.5)mm Hg、(26.6±10.5)mg/L、(188.4±65.2)ng/L(P<0.05)。两组总有效率比较,无统计学差异(χ^(2)=1.059,P=0.303>0.05),但联合组显效率83.3%高于静脉滴注组的61.1%(χ^(2)=4.431,P=0.035<0.05)。结论采用氨溴索治疗新生儿肺炎时,静脉滴注联合雾化吸入是更为理想的用药方式。

Objective To evaluate the effect of intravenous drip combined with atomization inhalation of ambroxol in the treatment of neonatal pneumonia.Methods A total of 72 neonates with pneumonia were studied and randomly divided into an intravenous drip group(n=36)and a combination group(n=36).The intravenous drip group was given intravenous drip of ambroxol on the basis of conventional treatment,and the combination group was given atomization inhalation of ambroxol on the basis of the control group.Both groups were compared in terms of time to symptom and sign resolution,length of hospital stay,blood gas indexes[arterial partial pressure of oxygen(PaO_(2))and arterial partial pressure of carbon dioxide(PaCO_(2))]and inflammation indexes[serum C-reactive protein(CRP)and interleukin-6(IL-6)]before treatment and 3 d after treatment,and the clinical efficacy.Results The duration of fever,shortness of breath,cough,pulmonary rales and length of hospital stay in the combination group were(3.1±1.3),(3.5±1.5),(5.2±1.7),(5.8±2.0)and(8.8±2.7)d,which were shorter than(3.9±1.5),(4.5±1.8),(6.3±2.3),(7.1±2.6)and(10.6±3.1)d in the intravenous drip group(P<0.05).3 d after treatment,the combination group had higher PaO_(2)of(76.0±9.1)mm Hg(1 mm Hg=0.133 kPa)than(70.1±8.7)mm Hg in the intravenous drip group;the combination group had PaCO_(2)of(45.1±4.3)mm Hg,serum CRP of(19.4±8.6)mg/L,and IL-6 of(141.6±51.7)ng/L,which were significantly lower than(47.7±5.5)mm Hg,(26.6±10.5)mg/L and(188.4±65.2)ng/L in intravenous drip group(P<0.05).There was no significant difference in the total effective rate between the two groups(χ^(2)=1.059,P=0.303>0.05),but the effective rate of 83.3%in the combination group was higher than 61.1%in the intravenous drip group(χ^(2)=4.431,P=0.035<0.05).Conclusion When using ambroxol to treat neonatal pneumonia,intravenous drip combined with atomization inhalation is a more ideal medication method.