摘要
目的:观察支气管镜灌洗与阿奇霉素联合用于小儿大叶性肺炎的治疗效果。方法:选择2021年该院收治的大叶性肺炎患儿200例,采用抽签法分为对照组和观察组,各100例。两组患儿入院后均行常规治疗;在此基础上,对照组患儿口服阿奇霉素治疗,连续治疗2周;观察组患儿在对照组的基础上进行支气管镜灌洗,根据患儿情况治疗2~3次。观察两组患儿临床症状改善时间,比较两组患儿治疗前、治疗2周时炎症指标[C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素6(IL-6)和高迁移率族蛋白B1(HMGB1)]、血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))和pH]水平,记录两组患儿不良反应发生情况。结果:相较于对照组,观察组患儿临床症状改善时间较短,差异有统计学意义(P<0.05)。治疗2周时,两组患儿血清CRP、PCT、IL-6和HMGB1水平明显降低,且观察组患儿明显更低,差异均有统计学意义(P<0.05)。治疗2周时,两组患儿PaO_(2)、pH明显升高,且观察组患儿明显更高;两组患儿PaCO_(2)明显降低,且观察组患儿明显更低,差异均有统计学意义(P<0.05)。观察组、对照组患儿治疗期间厌食、头晕、恶心、嗜睡、声音嘶哑和鼻黏膜出血等不良反应发生率的差异均无统计学意义(P>0.05)。结论:支气管镜灌洗联合阿奇霉素治疗小儿大叶性肺炎,可促进患儿临床症状改善,减轻机体炎症反应,改善血气指标,且不良反应轻微。
OBJECTIVE: To probe into the treatment effects of bronchoscopic lavage complicated with azithromycin in the treatment of children with lobar pneumonia. METHODS: Totally 200 children with lobar pneumonia admitted into the hospital in 2021 were extracted to be divided into the control group and the observation group via the lottery method, with 100 cases in each group. Both groups received routine treatment after admission, on this basis, the control group was treated with orally azithromycin for 2 weeks;and the observation group was given bronchoscopic lavage on the basis of the control group, from twice to 3 times according to the condition of the children. The improvement time of clinical symptoms in two groups was observed. The levels of inflammatory indicators [C-reactive protein(CRP), procalcitonin(PCT), interleukin 6(IL-6) and high mobility group protein B1(HMGB1)], blood gas indicators [partial pressure of arterial oxygen(PaO_(2)), partial pressure of arterial carbon dioxide(PaCO_(2)) and pH] before treatment and after treatment of 2 weeks were compared between two groups. The occurrence of adverse drug reactions was recorded in both groups. RESULTS: Compared with the control group, the improvement time of clinical symptoms of children in the observation group was shorter, with statistically significant difference(P<0.05). After treatment of 2 weeks, the levels of serum CRP, PCT, IL-6 and HMGB1 in both groups decreased significantly, and the observation group was even lower, with statistically significant differences(P<0.05). After treatment of 2 weeks, the PaO_(2)and pH values of both groups increased significantly, and the observation group was even higher, while PaCO_(2)in both groups decreased significantly, and the observation group was even lower, with statistically significant differences(P<0.05). There was no significant difference in the incidence of anorexia, dizziness, nausea, drowsiness, hoarseness and nasal mucosal bleeding between the observation group and the control group during treatment(P>0.05). CONCLUSIONS: Bronchoscopic lavage complicated with azithromycin in the treatment of lobar pneumonia can promote the improvement of clinical symptoms, reduce the inflammatory response and improve the blood gas indicators of children, with mild adverse drug reactions.
作者
任增志
林丽
马敬斌
王道昉
REN Zengzhi;LIN Li;MA Jingbin;WANG Daofang(Dept.of Pediatrics,The Second People’s Hospital of Liaocheng,Shandong Liaocheng 252600,China;Dept.of Anesthesiology,The Second People’s Hospital of Liaocheng,Liaocheng Second People’s Hospital Shandong Liaocheng 252600,China)
出处
《中国医院用药评价与分析》
2022年第12期1464-1467,共4页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
山东省医药卫生科技发展计划项目(No.202006011279)。
关键词
大叶性肺炎
阿奇霉素
支气管镜灌洗
炎症反应
血气指标
Lobar pneumonia
Azithromycin
Bronchoscopic lavage
Inflammatory reaction
Blood gas index
作者简介
任增志,主治医师。研究方向:儿科呼吸。E-mail:renzengzhi2019@126.com。
