布地奈德雾化联合经鼻持续气道正压通气治疗重症新生儿肺炎感染的疗效

Efficacy of budesonide atomization combined with tansnasal continuous positive airway pressure ventilation in the treatment of severe neonatal pneumonia infection

目的 分析布地奈德雾化联合经鼻持续气道正压通气(NPCAP)治疗重症新生儿肺炎感染的疗效.方法 选取2022年5月-2023年5月郑州大学第三附属医院收治的重症新生儿肺炎患儿,随机分为对照组(n=60)和联合组(n=60);两组均进行常规对症治疗,对照组在常规基础上给予NPCAP治疗,联合组在对照组基础上联合使用布地奈德雾化,均治疗一周;比较患儿临床疗效和不良反应率,血气分析检测治疗前后二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))、氧合指数、肺泡-动脉氧分压差(A-aDO_(2))、氧合指数(OI)水平;酶联免疫吸附法检测治疗前后C-反应蛋白(CRP)、降钙素原(PCT)和白细胞介素-6(IL-6).结果 联合组疗效优于对照组(P<0.05);治疗后,联合组PaCO_(2)低于对照组,PaO_(2)和氧合指数高于对照组(P<0.05);治疗后,联合组A-aDO_(2)低于对照组,OI高于对照组(P<0.05);治疗后,联合组CRP、PCT和IL-6低于对照组(P<0.05);两组治疗期间总不良反应率差异无统计学意义(P=0.509).结论 布地奈德雾化联合NPCAP治疗重症新生儿肺炎感染疗效明确,提高肺氧合功能,改善血气指标和炎症指标,且具有一定安全性.

OBJECTIVE To analyze the curative effect of budesonide atomization combined with nasal continuous positive airway pressure(NPCAP)in the treatment of severe pneumonia infection.METHODS Children with severe neonatal pneumonia admitted to the Third Affiliated Hospital of Zhengzhou University were enrolled between May 2022 and May 2023 were selected and randomly divided into a control group(n=60)and a combination group(n=6o).Both groups were treated with conventional symptomatic treatment,the control group was treated with NPCAP on a conventional basis,while the combination group was treated with budesonide atomization on basis of control group,and both groups were treated for 1 week.The clinical efficacy and adverse reaction rates were compared.The levels of partial pressure of carbon dioxide(PaCO_(2)),arterial partial pressure of oxygen(PaO_(2)),oxygenation index,difference of alveoli-arterial oxygen pressure(A-aDO_(2))and oxygenation index(OI)were detected by blood gas analyzer before and after treatment.The levels of serum C-reactive protein(CRP),procalcitonin(PCT)and interleukin-6(IL-6)were detected by enzyme-linked immunosorbent assay before and after treatment.RESULTS The efficacy of the combination group was better than that of control group(P<O.05).After treatment,PaCO_(2)in the combination group was lower than that in the control group,while PaO_(2) and oxygenation index were higher than those in the control group(P<0.05).After treatment,A-aDO_(2) in the combination group was lower than that in the control group,while OI was higher than that in the control group(P<o.05).After treatment,levels of CRP,PCT and IL-6 in the combination group were lower than those in the control group(P<0.05).There was no significant difference in total incidence of adverse reactions between the two groups during treatment(P=0.509).CONCLUSION The efficacy of budesonide atomization combined with NPCAP in the treatment of severe neonatal pneumonia infection is clear,which can improve pulmonary oxygenation function,blood gas indexes and inflammatory indexes,and has a certain degree of safety.