Effect of xiaoer feire kechuan oral solution on extrapulmonary injury induced by mycoplasma pneumoniae in infant wistar rats

Objective To observe the effect of Xiaoer Feire Kechuan oral solution on the extrapulmonary injury induced by Mycoplasma pneumoniae in infant Wistar rats. Methods Infant Wistar rats were infected intranasally with M. pneumoniae once a day for four days. In the treatment groups, Xiaoer Feire Kechuan oral solution was administered daily for four days beginning from the day of infection. On day 5, blood of the rats was collected, and blood routine and biochemistry indexes were measured. All rats were sacrificed, and the weight of brain, heart, liver, and kidney was measured to calculate the organ indexes. The GM1 and GALC-Ab content in brain tissue was determined by ELISA. Pathological changes in the brain, heart, liver, kidney, and cerebellum were observed by HE staining. Results Blood routine indexes fluctuated within the normal range in the infection control group and in three of the Xiaoer Feire Kechuan oral solution groups. The serum LDH, CK, and CRE in all three Xiaoer Feire Kechuan oral solution groups were distinctly lower than those in the infection control group (P < 0.01, P < 0.05). Rat brain index and GALC-Ab content in the brain tissue showed an increase in infection control group. In the Xiaoer Feire Kechuan oral solution groups, the GALC-Ab content in brain tissue was decreased significantly. The heart, liver, and kidney tissues showed mild pathological changes in the infection group, which were reversed by Xiaoer Feire Kechuan oral solution treatment. Conclusions The extrapulmonary injury induced by M. pneumoniae in infant Wistar rats was significantly inhibited by Xiaoer Feire Kechuan oral solution.

Dynamic changes of immune function and inflammatory factors in infants with mycoplasma pneumoniae infection in different stages

Objective:To investigate the levels of immune function and inflammatory factors in children with mycoplasma pneumonia (MP) infection in different stages and its clinical significance. Methods: A total of 100 children with MPP hospitalized from September 2014 to May 2015 were selected as the observation group and divided into two groups of MPP acute period and recovery period on the basis of the infection degree, and 50 healthy children were selected as control group at the same time, detect the immunoglobulin (IgG, IgA, IgM) and complement (C3, C4), peripheral T lymphocyte subsets (CD3+, CD4+, CD8+) and inflammatory factors (IL-2, IL-6, TNF-α, IL-8, IL-10, IL-13) of three groups of infants.Results:immunoglobulin IgG levels of recovery period were significantly higher than that in acute stage and the control group, IgA levels of acute phase and recovery phase were significantly lower than the control group, IgM and complement C3 levels in acute stage were significantly higher than the control group, during the recovery period tended to be normal, complement C4 in acute stage levels were significantly higher than those in recovery period and both higher than the control group. The CD3+, CD4+ and CD4/CD8 ratio of MPP in acute stage and recovery phase were significantly lower than the control group, and these numerical indexes of the recovery period were significantly higher than the acute stage, CD8+ levels in acute stage were significantly higher than that in recovery period and both higher than control group. Compared with the control group ,The levels of inflammatory cytokines IL-2 in the acute phase and recovery phase were significantly decreased, and the recovery period was significantly higher than that in acute stage, the test results that the levels of IL-6, TNF-α, IL-8, IL-10 and IL-13 in acute phase and recovery phase were significantly higher than those in control group and the recovery period was significantly lower than that in the acute stage.Conclusion:The body humoral immune function and cellular immune function damage caused by MP infection in infants and young children could lead to the disorder of immune system and the abnormal expression of inflammatory cytokines. Therefore, Therefore, the real-time monitoring the dynamic level of the indicators can define the infants and young children's condition, improve the recovery rate, and have a certain guiding significance of the clinical diagnosis of infants and young children .

Multidisciplinary approach to suspected sudden unexpected infant death caused by milk-aspiration:A case report

BACKGROUND The term sudden unexpected infant death(SUID)is not always properly invoked.It refers to a broad range of conditions that sometimes defy classification.There is not only a strong emotional impact on the family,but such cases are also quite complex.Underlying causes may be multiple,not always readily apparent,and have potential repercussions,especially in terms of forensics.CASE SUMMARY A 5-month-old male baby was pronounced dead following acute lung failure and cardiopulmonary arrest.The parents had immediately rushed their child to the hospital,stating the baby was found prone and not breathing.Total-body postmortem computed tomography(PMCT)was performed,revealing a hypodense material of indeterminate nature within the main airways and areas of ground-glass parenchymal change.At autopsy,the respiratory tract mucosa appeared edematous and was coated with a whitish stringy material.There was widespread airspace reduction due to parenchymal collapse.Alveolar sacs and bronchial openings contained abundant amorphous material admixed with white blood cells.Immunohistochemical studies were performed,targeting CD15,CD68,and alpha-lactalbumin.Ultimately,the focus was on alpha-lactalbumin(milk protein),which showed marked immunopositivity within alveolar spaces.Cytoplasmic staining of macrophages was also particularly prominent.CONCLUSION Postmortem investigations are thus essential to identify causes of death and surrounding circumstances.PMCT is a useful tool in this setting,given the frequent dearth of autopsy findings and ambiguity as to cause of death in SUID cases.These findings,later confirmed by immunohistochemical investigations,were indicative of active pneumonia due to aspirated milk.The present account illustrates the importance a broad diagnostic approach to SUID in cases of forensic concern.PMCT is a very valuable aid in cases of forensic interest,as it can provide useful information in all those situations in which the cause of death is uncertain or there are no suggestive dynamics or lesions.

Preventative effect of massage on gastric volvulus in infants with gastroesophageal reflux-induced pneumonia

OBJECTIVE:To study the preventative effects of massage on gastric volvulus(GV) in infants with gastroesophageal reflux(GER)-induced pneumonia.METHODS:One-hundred and eighty GV with GER-induced pneumonia inpatients were divided randomly into four groups:basic treatment 1(n =60),basic treatment 2(n = 30),massage treatment1(n = 60) and massage treatment 2(n = 30).Clinical examinations selected between groups 1 and 2were different.Radiography of the upper gastrointestinal tract using iodine-containing contrast was assessed in group 1 before and after treatment,whereas 24-h pH monitoring of the distal esophagus was assessed in group 2 before and after treatment.Symptom scores and chest radiography were assessed in all groups upon hospital admission and after procedures.Clinical effects were estimated after procedures in all groups.The prevalence of severe pneumonia among the four groups was compared.RESULTS:Massage treatment groups showed a significantly higher percentage of cure and total effect(P<0.05,P<0.01) and a lower prevalence of recurrence(but with no statistic difference,P>0.05)than basic treatment groups.Furthermore,massage treatment groups had remarkably lower scores for symptoms and signs(P<0.05,P<0.01),especially for choking on milk,than basic treatment groups.There was significant attenuation of chest inflammation(P<0.05,P<0.01),GV(P<0.05,P<0.01) and GER(P<0.05,P<0.01) in massage treatment groups compared with those in basic treatment groups.Finally,massage treatment groups demonstrated a lower prevalence of severe pneumonia than basic treatment groups(P<0.05).CONCLUSION:Massage treatment can prevent GV with GER-induced pneumonia in infants by timely correction of stomach rotation and subsequent attenuation of GER.

Cardiovascular characteristics of premature infants with Klebsiella Pneumoniae septicemia and shock

Background The cardiovascular characteristics during septic shock in premature neonates are characterized by elevated ventricular output and normal ejection fraction.However,there is little knowledge about other variables in premature infants with Klebsiella Pneumoniae(KPN)septicemia and shock.This study aimed to investigate the characteristics of cardiovascular changes in premature infants diagnosed with Klebsiella pneumonia(KPN)septicemia and shock.Methods Our study included premature infants(gestational age≤34 weeks)in the neonatal intensive care unit(NICU)of Guangdong Provincial People.s Hospital from November 1 st,2013 to November 31 st,2016.17 participants diagnosed with KPN septicemia complicated with shock and 17 healthy premature infants were respectively enrolled in study group and control group for analysis.All the infants underwent non-invasive ultrasound cardiac output monitor examinations in normal time,early stage of shock and cured time.Results Compared with the control group,higher values of heart rate(HR)(P<0.001),cardiac output index(CI)(P<0.001),Smith-Madigan inotropy index(SMII)(P<0.001)and oxygen delivery(DO2)(P<0.001),and lower levels of systemic vascular resistance index(SVRI)(P<0.001)were observed in the study group.The difference of mean blood pressure(MBP)was not statistically significant(P=0.943).In the study group,the values of HR(P=0.004),CI(P=0.004),SMII(P=0.004)and DO2(P=0.004)in the early stage of septic shock were significantly higher when compared with the values in the normal time,while the value of SVRI(P<0.001)was significantly lower.HR(P<0.001)and DO2(P=0.009)decreased from the early stage of septic shock to the cured time,while SVRI(P<0.001)increased.There were no significant changes in CI(P>0.999)and SMII(P=0.646)from early stage of septic shock to improvement in the study group.Conclusions Systemic vascular resistance index decreased and oxygen deliver elevated in preterm infants with gestational age less than 34 weeks with Klebsiella Pneumoniae septicemia and shock.Vasoregulatory failure may be the main cause of Klebsiella Pneumoniae septicemia and shock.Vasoactive drugs may be needed during shock.The increase of oxygen deliver level in the early stage of shock indicates that timely and effective vasoactive infusion can prevent the deterioration of the disease.

Effect of zinc supplementation on infants with severe pneumonia

Background:Pneumonia is a common respiratory infectious disease in infancy.Previous work shows controversial results on the benefit of zinc supplementation in patients with pneumonia.We conducted this study to investigate serum zinc status amongst infants with severe pneumonia and the clinical impact that zinc supplementation has on those patients with low serum zinc levels.Methods:This study design was a non-blinded prospective randomized controlled trial.The study is approved by the Ethics Committees of Beijing Children's Hospital.A total of 96 infants diagnosed with severe pneumonia and hospitalized in the pediatric intensive care unit between November 2011 and January 2012 were enrolled.Enrolled patients were divided into low serum zinc and normal serum zinc group.The low serum zinc group was randomized into treatment and control groups.Only the treatment group received zinc supplementation within 48-72 hours after hospitalization.Results:The prevalence of zinc defi ciency on admission was 76.0%.The low zinc level was most apparent in infants between 1 and 3 months of age.The serum zinc level increased in the zinc treatment group and returned to a normal level(median,53.20μmol/L)on day 12±2.There was no statistical difference in the pediatric critic illness score,lung injury score,length of hospital stay,and duration of mechanical ventilation between the zinc treatment group and control group.Conclusions:Zinc deficiency is common in infants with severe pneumonia.Normalization of zinc levels with zinc supplementation did not improve clinical outcomes of infants with pneumonia.

支气管哮喘患儿持续性气流受限的影响因素分析

目的探讨支气管哮喘患儿持续性气流受限(persistent airflow limitation,PAL)的影响因素。方法选取2021年1—12月首都儿科研究所附属儿童医院就诊的5~17岁PAL哮喘患儿(病例组)和同期就诊的非PAL哮喘患儿(对照组),每组50例。采集两组患儿临床资料,比较个人史、哮喘发作、过敏状况、呼吸道感染、肺功能水平等,采用多因素logistic回归方程分析PAL的影响因素。结果100例患儿中,男78例、女22例;年龄(9.5±2.2)岁。多因素logistic回归分析结果显示,既往肺炎史(OR=5.863,95%CI:2.295~14.975,P<0.01)、哮喘最严重一年发作次数越高(OR=1.599,95%CI:1.079~18.436,P<0.01)的患儿越容易发生PAL。结论哮喘患儿发生PAL起病早,肺炎史、哮喘频繁发作是患儿发生PAL的危险因素。应重视预防感染、减少呼吸道感染次数,合理用药,控制支气管哮喘发作,以减少PAL的发生。

血清IgG、白细胞介素-6、维生素D检测在肺炎支原体感染合并支气管哮喘患儿中的应用研究

目的:分析血清免疫球蛋白G(IgG)、白细胞介素-6(IL-6)、维生素D检测在肺炎支原体(MP)感染合并支气管哮喘患儿中的应用价值.方法:选取2018年1月—2022年8月广州医科大学附属第二医院儿科住院部收治的MP感染患儿103例为研究对象,根据是否合并支气管哮喘,分为未合并哮喘组(n=68)及合并哮喘组(n=35).分别采用酶联免疫法、电化学发光法、液相色谱串联质谱检测患儿血清IgG、IL-6、维生素D水平.结果:合并哮喘组血清IgG、IL-6水平高于未合并哮喘组,维生素D水平低于未合并哮喘组,差异有统计学意义(P<0.001);Pearson相关系数分析结果显示,MP感染合并支气管哮喘发生率与血清IgG、IL-6水平呈正相关(r=0.925,P=0.029;r=0.931,P=0.048),与血清维生素D水平呈负相关(r=-0.964,P=0.021).结论:血清IgG、IL-6、维生素D水平可有效反映MP感染合并支气管哮喘患儿的病情,为其后续治疗提供参考依据.

肺超声在1~3月龄婴儿社区获得性肺炎病情评估中的价值

目的探讨肺部超声评分(lung ultrasound score,LUSS)在1~3月龄婴儿社区获得性肺炎(community acquired pneumonia,CAP)病情评估的临床应用价值。方法收集1~3月龄且在入院48小时内完成肺超声检查的CAP患儿的临床资料,对病情程度进行定量评分及分级,分析病情程度与LUSS的相关性,应用ROC曲线评价LUSS对重症肺炎的评估价值。结果重症肺炎组LUSS[12.0(6.0,21.5)]分高于轻症肺炎组[3.0(1.0,8.0)]分(P<0.05),病情严重程度与LUSS呈显著正相关(r=0.487,P<0.01),ROC曲线判断重症肺炎最佳界限为5.5分,敏感度和特异度分别为81.8%、69.6%。结论LUSS可反映小于3月龄CAP患儿的病情严重程度,是临床评估病情的实用工具,可作为病情随访监测的工具。

以慢性咳嗽为主要症状的成人隐匿性支气管异物延迟诊治及文献复习

目的探讨成人隐匿性支气管异物的临床特点与诊治经验。方法结合文献回顾性分析2017年2月—2023年7月收治的4例成人隐匿性支气管异物病例资料。结果4例中仅1例存在脑血管意外导致长期卧床,误吸发生支气管异物,其余3例均为正常成人。临床表现主要为慢性咳嗽。误诊为肺炎2例、肺脓肿、支气管炎各1例,后经支气管镜检查确诊。确诊后3例在全麻下行支气管异物摘除术,另一例在局麻气管镜失败后改为全麻下治疗,无并发症发生。4例中1例为动物性异物(鸭脖),2例为植物性异物(瓜子仁、菜叶、菜梗、辣子角),1例为金属物品(锡纸)。误诊时间3个月~10年。结论成人支气管异物少见,临床表现各异,非金属样异物或植物性异物在胸部影像学检查的早期多数呈阴性结果,使得不能及时诊断及治疗,导致肺不张及肉芽组织增生,引起反复肺炎。成人支气管异物存在误诊率高、延误诊断时间长的特点。全麻下气管镜诊治是诊断和治疗隐匿性支气管异物最为有效的方法。

重组人干扰素α2b联合复方异丙托溴铵在支气管哮喘合并病毒性肺炎患儿治疗中的应用

目的:分析重组人干扰素α2b联合复方异丙托溴铵治疗儿童支气管哮喘合并病毒性肺炎的临床效果。方法:选取某院2021年5月~2023年5月收治的140例支气管哮喘合并病毒性肺炎患儿为研究对象,采用随机数字表法分为对照组和观察组,每组70例。两组患儿均接受常规治疗,对照组在此基础上予以复方异丙托溴铵治疗,观察组在对照组基础上加用重组人干扰素α2b治疗,均连续治疗7天。治疗结束,比较两组患儿治疗总有效率和发热、肺部阴影、咳嗽、肺部啰音等症状的消失时间,记录患儿在治疗过程中是否发生不良反应。结果:治疗7天后,观察组治疗有效率(92.86%)高于对照组(72.86%,P<0.05);观察组退热、肺部阴影消失、咳嗽消失、肺部啰音消失等时间均短于对照组(P<0.05);两组患儿在用药治疗期间均没有出现不良反应。结论:重组人干扰素α2b联合复方异丙托溴铵治疗儿童支气管哮喘合并病毒性肺炎整体疗效较好,有助于主要症状较快缓解且不会增加不良反应发生风险。

支气管哮喘合并肺炎支原体感染患儿血清Periostin、sIL-2R水平变化及其与血清炎症因子、肺功能相关性分析

目的探究支气管哮喘合并肺炎支原体(MP)感染患儿血清骨膜蛋白(Periostin)、可溶性白细胞介素-2受体(sIL-2R)水平变化及其与血清炎症因子、肺功能的相关性。方法选择2021年9月至2023年9月本院收治的支气管哮喘合并MP感染患儿(感染组)、单纯支气管哮喘患儿(哮喘组)及同期体检的健康儿童(对照组)各60例。采用酶联免疫吸附法检测血清Periostin、sIL-2R水平。采用Pearson相关性分析支气管哮喘合并MP患儿血清Periostin、sIL-2R水平与炎症因子、肺功能的相关性。结果感染组、哮喘组、对照组血清Periostin、sIL-2R水平均依次降低(P<0.05)。感染组、哮喘组、对照组血清干扰素(IFN)-γ、白细胞介素(IL)-4、IL-8、肿瘤坏死因子(TNF)-α水平均依次降低(P<0.05)。感染组、哮喘组第1秒用力呼气容积(FEV1)/用力肺活量(FVC)均低于对照组(P<0.05);感染组、哮喘组、对照组最大呼气流量(PEF)依次升高(P<0.05)。支气管哮喘合并MP感染患儿血清Periostin、sIL-2R水平均与IFN-γ、IL-4、IL-8、TNF-α水平呈正相关,均与PEF呈负相关(P<0.05)。结论支气管哮喘合并MP感染患儿血清Periostin、sIL-2R水平较高,与患儿血清炎症因子、肺功能密切相关。

经鼻无创高频振荡通气在治疗婴幼儿重症肺炎方面的临床应用

目的通过经鼻无创高频振荡通气(Nasal non-invasive high frequency oscillatory ventilation,n HFOV)与经鼻持续气道正压通气(nasal continuous positive airway pressure n CPAP)这两种通气模式在婴幼儿重症肺炎中的无创辅助通气,探究初始治疗中的临床效果及并发症的发生。方法选取2020.06至2022.06在新生儿重症监护病房(neonatal intensive care unit,NICU)住院的合并呼吸衰竭的婴幼儿肺炎(14d-3m)57例,随机分为观察组(n HFOV组)(27例)及对照组(n CPAP组)(30例);比较两组患儿在无创呼吸机治疗4-6小时后的相关血气分析数据变化,治疗的成功率,上机时间,二氧化碳变化率及各种不良反应的发生率。结果n HFOV组和n CPAP组相比,n HFOV组初始治疗的成功率,呼吸机应用时间,喂养不耐受及心动过速发生率,治疗6小时后PCO_(2)变化率,经统计学分析,均有明显差异,(P<0.05)差异有统计学意义;在鼻中隔损伤、消化道出血等并发症的发生率方面,经统计学分析,差异无统计学意义。结论n HFOV作为婴幼儿重症肺炎的初始无创通气模式,n HFOV临床应用效果明显优于n CPAP,在喂养不耐受及心动过速等并发症发生率方面有明显的差异,可以作为一种创伤性小的无创通气模式,应用于婴幼儿重症肺炎的治疗中,从而最大限度地避免了有创机械通气的应用,减少相关并发症的发生。

妊娠期糖尿病患者肠道菌群与新生儿免疫及肺炎易感性的关系

目的探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)患者孕晚期肠道菌群与新生儿免疫功能及对新生儿感染性肺炎易感性的关系。方法选取我院收治的孕晚期GDM患者245例,根据新生儿感染性肺炎发生情况分为感染组(n=27)、无感染组(n=218),比较2组基线资料、产妇孕晚期肠道菌群(Chao1指数、Shannon指数、Bray Curtis距离)、新生儿免疫功能[CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞、免疫球蛋白A(immunoglobulin A,IgA)、免疫球蛋白G(immunoglobulin G,IgG)、免疫球蛋白M(immunoglobulin M,IgM)],应用Pearson分析孕晚期肠道菌群与新生儿免疫功能的相关性,应用多因素Logistic回归方程分析新生儿感染性肺炎的相关影响因素,应用受试者工作特征(receiver operating characteristic,ROC)曲线及ROC下面积(area under the curve,AUC)分析各指标预测新生儿感染性肺炎的价值。结果感染组与无感染组分娩前血糖达标情况比较,差异有统计学意义(P<0.05);感染组Chao1指数、Shannon指数、CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞、IgG低于无感染组,Bray Curtis距离大于无感染组(P<0.05);将分娩前血糖达标情况控制后,Chao1指数、Shannon指数、Bray Curtis距离、CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞、IgG仍与新生儿感染性肺炎的易感性相关(P<0.05);Chao1指数、Shannon指数、Bray Curtis距离、CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞、IgG预测新生儿感染性肺炎的AUC依次为0.754、0.814、0.771、0.779、0.817、0.775、0.840(P<0.05)。结论GDM患者孕晚期肠道菌群可影响新生儿细胞免疫和体液免疫功能,均与新生儿感染性肺炎易感性有关,可作为预测新生儿感染性肺炎的一种新方法。

穴位敷贴配合童趣化健康宣教在小儿支气管肺炎护理中的应用

目的:观察穴位敷贴配合童趣化健康宣教在小儿支气管肺炎护理中的应用效果。方法:选取支气管肺炎患儿88例,按照随机数字表法分为观察组和对照组,各44例。给予观察组穴位敷贴配合童趣化健康宣教,给予对照组常规干预,观察两组依从性、症状评分、体温恢复正常时间、咳嗽消失时间、肺部啰音消失时间及生活质量,比较两组护理满意度。结果:干预后观察组依从性、护理满意度高于对照组,体温恢复正常时间、咳嗽消失时间、肺部啰音消失时间早于对照组,症状积分、生活质量评分低于对照组,差异有统计学意义(P<0.05)。结论:穴位敷贴配合童趣化健康宣教可有效改善支气管肺炎患儿的依从性,减轻临床症状,提高生活质量及护理满意度。

以右肺中叶肺不张、肺实变为主要影像表现的老年女性支气管色素沉着纤维化延迟诊治分析

目的分析以右肺中叶肺不张、肺实变为主要影像表现的支气管色素沉着纤维化(BAF)患者临床特点、误诊原因。方法回顾分析2023年1—12月收治的5例以右肺中叶肺不张、肺实变为主要影像学表现且经气管镜确诊的老年BAF患者的诊治过程。结果5例老年女性,年龄67~75岁,长期生活在农村,有常年生物燃料使用史。5例以慢性咳嗽、胸闷、活动后气短为主要临床表现,胸部CT提示右肺中叶肺不张3例、右肺中叶肺实变2例,2例有高血压基础疾病,5例均无吸烟史。误诊为肺炎1例,支气管哮喘1例,慢性支气管炎1例,慢性阻塞性肺疾病1例,肺占位性病变1例。5例最终经气管镜确诊为BAF,误诊时间2 d~20年,5例接受双支气管扩张剂吸入及对症支持等治疗,均好转出院。结论BAF早期无特异性症状,实验室和影像学检查无特异性,容易误漏诊。确诊该病需要依靠病史、临床、影像学、气管镜检查综合判断。对于既往常年使用生物燃料烹饪、取暖,影像学检查提示以右肺中叶肺不张、右肺中叶肺实变影为主要征象的老年女性患者,一定要行气管镜检查,排除BAF可能。

细节化护理在支气管肺炎患儿雾化治疗中的应用效果及对患儿依从性、治疗效果及情绪状态的影响

目的 观察细节化护理在支气管肺炎患儿雾化治疗中的应用效果及对患儿依从性、治疗效果及情绪状态的影响。方法 选取我院2020年1月至2021年6月收治的86例支气管肺炎患儿为研究对象,按入院号奇偶数字表法将其分为对照组和观察组,各43例。雾化治疗期间,对照组实施常规护理,观察组实施细节化护理。比较两组的护理效果。结果 观察组的护理总依从率明显高于对照组(P<0.05)。观察组的咳嗽、气喘、发热、肺部啰音消失时间及住院时间均短于对照组(P<0.05)。护理后,两组的用力肺活量(FVC)、第1秒用力呼吸容积(FEV1)、呼气峰值流速(PEF)及最大呼气中期流量(MMEF)均升高,且观察组高于对照组(P<0.05)。护理后,两组的改良面部表情评分法(FLACC)、儿童医疗恐惧量表(CFMS)评分均降低,且观察组低于对照组(P<0.05)。结论 细节化护理应用于支气管肺炎患儿雾化治疗中可提高患儿依从性,促进临床症状、肺功能的改善,还可改善患儿雾化治疗中的情绪状态,值得临床应用。

乙酰半胱氨酸联合布地奈德雾化吸入治疗婴幼儿肺炎的临床效果分析

目的:分析乙酰半胱氨酸联合布地奈德雾化吸入治疗婴幼儿肺炎的临床效果。方法:选取2020年8月—2022年8月滨州市中心医院收治的婴幼儿肺炎患者100例作为研究对象,随机分为对照组和观察组,各50例。对照组采取雾化吸入布地奈德治疗,观察组在对照组基础上联合雾化吸入乙酰半胱氨酸溶液治疗。比较两组治疗效果、炎性因子水平、症状消失时间和不良反应发生率。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=0.009)。治疗前,两组白细胞介素6(IL-6)、淀粉样蛋白A(SAA)、C反应蛋白(CRP)水平比较,差异无统计学意义(P>0.05);治疗后,两组IL-6、CRP、SAA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)。观察组呼吸困难、咳嗽、发热消失时间短于对照组,差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:乙酰半胱氨酸溶液联合布地奈德雾化吸入治疗婴幼儿肺炎的临床效果显著,能够有效改善患儿临床症状,减轻炎性反应,且安全性较高。

辅助通气治疗的RDS早产儿发生VAP的危险因素

目的:探究辅助通气治疗的呼吸窘迫综合征(RDS)早产儿发生呼吸机相关性肺炎(VAP)的危险因素。方法:选择2020年5月至2022年5月于泉州市第一医院接受辅助通气治疗的RDS早产儿100例为观察目标,统计辅助通气期间VAP发生率,按照有无VAP发生分成VAP组和无VAP组,通过单因素与多因素Logistic回归分析法对RDS早产儿辅助通气期间VAP发生危险因素予以分析。结果:100例RDS早产儿在辅助通气治疗期间发生VAP者34例、未发生VAP者66例,VAP发生率是34%(34/100);单因素分析显示,VAP组早产儿的有创机械通气治疗时间、拔管后无创通气治疗时间、新生儿窒息率、新生儿抢救率、重复插管上机治疗次数均高于无VAP组,差异有统计学意义(P<0.05);多元Logistic回归分析显示,有创机械通气治疗时间、拔管后无创通气治疗时间、新生儿窒息、新生儿抢救、重复插管上机治疗次数>3次为RDS早产儿辅助通气治疗期间VAP发生的独立危险因素(P<0.05)。结论:RDS早产儿辅助通气期间受机械通气治疗时间、新生儿窒息及重复插管上机治疗次数等因素影响,存在较高的VAP发生可能性。

经鼻持续气道正压通气联合多巴胺与多巴酚丁胺治疗婴幼儿重症肺炎的临床价值

目的探讨经鼻持续气道正压通气联合多巴胺、多巴酚丁胺治疗婴幼儿重症肺炎的临床价值。方法选取2020年1月至2022年7月抚州市第一人民医院收治的80例婴幼儿重症肺炎患儿作为研究对象,随机分为对照组与观察组,各40例。对照组采用经鼻持续气道正压通气疗法,观察组在对照组基础上联合多巴胺、多巴酚丁胺治疗,比较两组呼吸机应用时间、治疗5 d后心力衰竭发生率、临床疗效、症状体征恢复时间、心率、呼吸频率及肺功能指标。结果观察组呼吸机应用时间短于对照组,治疗5 d后心力衰竭发生率低于对照组,差异有统计学意义(P<0.05)。观察组临床病情控制优良率为95.00%,高于对照组的77.50%,差异有统计学意义(P<0.05)。观察组肺部湿啰音消失时间、三凹征消失时间、心率恢复正常时间、呼吸频率恢复正常时间均短于对照组,差异有统计学意义(P<0.05)。治疗5 d后,观察组心率、呼吸频率均慢于对照组,差异有统计学意义(P<0.05)。治疗5 d后,观察组FEV1、FVC、FEV1/FVC均大于对照组,差异有统计学意义(P<0.05)。结论将经鼻持续气道正压通气联合多巴胺与多巴酚丁胺疗法治疗婴幼儿重症肺炎效果显著,能缩短呼吸机应用时间及症状体征恢复时间,降低心力衰竭发生率,促进心率及呼吸频率恢复正常,改善患儿肺功能。