经支气管镜保留灌注乙酰半胱氨酸+异丙托溴铵治疗儿童重症肺炎的疗效及安全性研究  

Study on the Efficacy and Safety of Reserved Bronchoscopic Infusion of Acetylcysteine Combined with Ipratropium Bromide in the Treatment of Severe Pneumonia in Children

作　　者：刘钰 徐慧 郑敏[1] LIU Yu;XU Hui;ZHENG Min(Xinfeng County People's Hospital,Jiangxi,Xinfeng341600)

机构地区：[1]江西省信丰县人民医院,信丰341600

出　　处：《实用中西医结合临床》2023年第23期5-8,26,共5页Practical Clinical Journal of Integrated Traditional Chinese and Western Medicine

基　　金：江西省赣州市指导性科技计划项目(编号:20222ZDX8549)。

摘　　要：目的:探讨经支气管镜保留灌注乙酰半胱氨酸+异丙托溴铵治疗儿童重症肺炎(SP)的疗效及安全性。方法:选择2022年1月至2023年6月就诊于江西省信丰县人民医院的40例SP患儿,按随机对照原则分为对照组(20例,接受常规治疗+经支气管镜生理盐水肺泡灌洗治疗)、研究组(20例,接受常规治疗+经支气管镜保留灌注乙酰半胱氨酸+异丙托溴铵治疗),共治疗1周。对比两组临床疗效、临床症状消失时间、炎症因子指标、血气指标、并发症发生率。结果:研究组总有效率比对照组高,发热、咳嗽、气促、肺部啰音消失时间均短于对照组(P<0.05);研究组治疗后血清白细胞介素-6(IL-6)、C反应蛋白(CRP)、降钙素原(PCT)水平均比对照组低(P<0.05);治疗后研究组血氧饱和度(SaO_(2))、动脉血氧分压(PaO_(2))水平均比对照组高,动脉血二氧化碳分压(PaCO_(2))水平比对照组低(P<0.05);治疗期间两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:经支气管镜保留灌注乙酰半胱氨酸+异丙托溴铵治疗儿童SP,可更好地促进临床症状消失,改善血气指标,降低炎症因子,提升临床疗效,且安全性较好。Objective:To investigate the efficacy and safety of reserved bronchoscopic infusion acetylcysteine combined with ipratropium bromide in the treatment of severe pneumonia(SP)in children.Methods:A total of 40 children with SP admitted to the Xinfeng County People's Hospital of Jiangxi Province from January 2022 to June 2023 were selected and randomly divided into a control group(20 cases received conventional treatment+bronchoscopic saline alveolar lavage treatment)and a study group(20 cases received conventional treatment+reserved bronchoscopic infusion of acetylcysteine+ipratropium bromide treatment)according to the principle of randomized control.The treatment lasted for 1 week.The clinical efficacy,time of clinical symptom disappearance,inflammatory factor indexes,blood gas indexes and incidence of complications were compared between the two groups.Results:The total effective rate of the study group was higher than that of the control group,and the disappearance time of fever,cough,shortness of breath,shortness of breath and lung rales was shorter than that of the control group(P<0.05).After treatment,the levels of serum interleukin-6(IL-6),C-reactive protein(CRP),and procalcitonin(PCT)in the study group were lower than those in the control group(P<0.05).After treatment,the levels of blood oxygen saturation(SaO_(2))and arterial partial pressure of oxygen(PaO_(2))in the study group were higher than those in the control group,while the levels of arterial partial pressure of carbon dioxide(PaCO_(2))was lower than that in the control group(P<0.05).There was no significant difference in the incidence of complications between the two groups during the treatment(P>0.05).Conclusion:Reserved bronchoscopic infusion of acetylcysteine+ipratropium bromide can better promote the disappearance of clinical symptoms,improve blood gas indexes,reduce inflammatory factors,improve clinical efficacy,and have good safety.

关 键 词：重症肺炎 经支气管镜灌洗 乙酰半胱氨酸 异丙托溴铵 炎症因子 血气指标 

分 类 号：R563.1[医药卫生—呼吸系统]