俯卧位机械通气配合布地奈德雾化吸入疗法对重症肺炎患儿肺功能与免疫功能的影响

Effect of Prone Mechanical Ventilation Combined with Budesonide Atomization Inhalation Therapy on Lung Function and Immune Function in Children with Severe Pneumonia

目的探讨俯卧位机械通气配合布地奈德雾化吸入疗法对重症肺炎患儿肺功能与免疫功能的影响。方法便利选取2023年3月—2024年3月贵阳市妇幼保健院收治的236例重症肺炎患儿为研究对象,根据治疗方法不同分为普通组(118例)和配合组(118例)。所有患儿均接受布地奈德雾化吸入疗法,普通组患儿采用普通俯卧位机械通气,配合组患儿采用俯卧位机械通气,对比两组患儿的肺功能[用力肺活量(forced vital capacity,FVC)、呼气峰值体积流量(peak expiratory flow,PEF)、第1秒钟用力呼气容积(forced expiratory vol⁃ume in the first second,FEV_(1))]、免疫功能和不良反应发生情况。结果治疗前,两组患儿的肺功能指标对比,差异无统计学意义(P>0.05)。治疗后,配合组患儿的FVC、PEF、FEV_(1)均高于普通组,差异有统计学意义(P均<0.05)。治疗前,两组患儿的免疫功能指标对比,差异无统计学意义(P>0.05)。治疗后,配合组患儿的成熟T淋巴细胞(cluster of differentiation 3^(+),CD3^(+))、辅助性T淋巴细胞(cluster of differentiation 4^(+),CD4^(+))、CD4^(+)/CD8^(+)均高于普通组患儿,差异有统计学意义(P均<0.05)。配合组患儿不良反应发生率为3.39%(4/118),低于普通组患儿的5.93%(7/118),差异无统计学意义(χ^(2)=0.858,P>0.05)。结论针对重症肺炎患儿,应用俯卧位机械通气配合布地奈德雾化吸入疗法能实现较为理想的临床效果,患儿肺功能与免疫功能得到了有效改善,且安全性较高。

Objective To investigate the effects of prone mechanical ventilation combined with budesonide atomization inhalation therapy on lung function and immune function in children with severe pneumonia.Methods A total of 236 children with severe pneumonia admitted to Guiyang Maternal and Child Health Hospital from March 2023 to March 2024 were conveniently selected as the research objects.According to the different therapeutic methods,they were divided into general group(118 cases)and cooperation group(118 cases).All children received budesonide atomization inhalation therapy.The children in the general group were treated with general prone position mechanical ventilation,and the children in the cooperation group were treated with prone position mechanical ventilation.The lung function[forced vital capacity(FVC),peak expiratory flow(PEF),forced expiratory volume in the first second(FEV_(1))],immune function and adverse reactions were compared between two groups.Results Before treatment,there was no significant difference in the lung function between the two groups(P>0.05).After treatment,the FVC,PEF and FEV_(1) in the cooperation group were higher than those in the general group,and the differences were statistically significant(all P<0.05).Before treatment,there was no significant difference in the immune function between the two groups(P>0.05).After treatment,the CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the cooperation group were higher than those in the general group,and the differences were statistically significant(all P<0.05).The incidence of adverse reactions in the combined group was 3.39%(4/118),which was lower than 5.93%(7/118)in the general group,and the difference was not statistically significant(χ^(2)=0.858,P>0.05).Conclusion For children with severe pneumonia,the application of prone position mechanical ventilation combined with budesonide atomization inhalation therapy can achieve ideal clinical results.The lung function and immune function of children have been effectively improved,and the safety is high.