排痰机联合小剂量甲强龙治疗儿童难治性支原体肺炎的临床疗效

Clinical efficacy of expectoration machine combined with low-dose methylprednisolone in the treatment of children with refractory mycoplasma pneumonia

目的探讨排痰机联合小剂量甲强龙治疗儿童难治性支原体肺炎的临床疗效。方法选取2020年1月至2022年1月菏泽市第六人民医院收治的81例儿童难治性支原体肺炎患儿作为研究对象,采用随机数字表法分为观察组(n=41)与对照组(n=40)。对照组给予常规吸氧、化痰、维持水电解质平衡治疗,同时给予阿奇霉素联合小剂量甲强龙治疗,观察组加用排痰机,比较两组临床疗效、炎症因子水平、肺功能指标、血气分析指标、不良反应发生情况。结果观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组白细胞介素-6、肿瘤坏死因子-α及高敏C反应蛋白水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组达峰容积比(expiratory volume at tidal peak expiratory flow/expiratory time,VPEF/VE)及达峰时间比(time to tidal peak expiratory flow/expiratory time,TPTEF/TE)均高于治疗前,每公斤体质量潮气量均大于治疗前,且观察组VPEF/VE、TPTEF/TE均高于对照组,每公斤体质量潮气量大于对照组,差异有统计学意义(P<0.05)。治疗后,两组氧合指数(partial pressure of arterial oxygen/fraction of inspiration O2,PaO2/FiO2)、动脉血氧分压(partial pressure of arterial oxygen,PaO2)均高于治疗前,动脉血二氧化碳分压(partial pressure of carbon dioxide in arterial blood,PaCO2)低于治疗前,且观察组PaO2/FiO2、PaO2均高于对照组,PaCO2低于对照组,差异有统计学意义(P<0.05)。两组均未发生不良反应。结论排痰机联合小剂量甲强龙可提高儿童难治性支原体肺炎治疗效果,减轻炎症反应,改善肺功能,调节血气指标,且安全性较高。

Objective To investigate the clinical efficacy of expectoration machine combined with low-dose methylprednisolone in the treatment of refractory mycoplasma pneumonia in children.Methods A total of 81 children with refractory mycoplasma pneumonia admitted to The Sixth People's Hospital of Heze City from January 2020 to January 2022 were selected as the research subjects,and they were divided into the observation group(n=41)and the control group(n=40)by random group table method,the control group was given conventional oxygen inhalation,phlegm removal,maintenance of water and electrolyte balance treatment,and azithromycin combined with low-dose methylprednilone treatment,while the observation group was added with expectoration machine.The clinical efficacy,inflammatory factor levels,pulmonary function indicators,blood gas analysis indicators,adverse reactions were compared between the two groups.Results The total effective rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of interleukin-6,tumor necrosis factor-αand hypersensitive C-reactive protein of the two groups were lower than those before treatment,and the observation group was lower than that in the control group,and the differences were statistically significant(P<0.05).After treatment,the expiratory volume at tidal peak expiratory flow/expiratory time(VPEF/VE)and time to tidal peak expiratory flow/expiratory time(TPTEF/TE)of the two groups were higher than those before treatment,and the tidal volume per kilogram of body mass was higher than that before treatment,and the VPEF/VE and TPTEF/TE in the observation group were higher than those in the control group,the tidal volume per kilogram of body weight was greater than that in the control group,and the differences were statistically significant(P<0.05).After treatment,the partial pressure of arterial oxygen/fraction of inspiration O2(PaO2/FiO2)and partial pressure of arterial oxygen(PaO2)of the two groups were higher than those before treatment,the partial pressure of carbon dioxide in arterial blood(PaCO2)was lower than that before treatment,PaO2/FiO2 and PaO2 in the observation group were higher than those in the control group,PaCO2 was lower than that in the control group,the differences were statistically significant(P<0.05).No adverse reactions occurred between the two groups.Conclusion Expectoration machine combined with low-dose methylprednilone can improve the treatment effect of refractory mycoplasma pneumonia in children,reduce inflammation,improve lung function,regulate blood gas indexes,and with high safety.