摘要
目的探讨乙酰半胱氨酸溶液经支气管镜灌洗治疗儿童大叶性肺炎的效果及对肺功能和血清炎性指标的影响。方法选取2020年9月至2023年8月福州肺科医院儿科接收并治疗的90例大叶性肺炎患儿。采取随机数字表法将患者随机分为两组,将在常规治疗基础上实施氯化钠注射液(生理盐水)支气管镜肺泡灌洗治疗的45例纳入对照组,在常规治疗基础上给予乙酰半胱氨酸支气管镜灌洗治疗的45例纳入观察组。灌洗治疗后7 d评估两组临床疗效,比较两组治疗前及灌洗治疗后7 d肺功能[最大呼气流量(PEF)、第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)及FEV_(1)/FVC比值]、血清炎症指标[C反应蛋白(CRP)、白细胞介素-6(IL-6)及降钙素原(PCT)]的变化,并观察两组肺泡灌洗治疗后临床症状改善时间及治疗期间不良反应发生情况。结果相较于对照组,观察组总有效率更高,但组间差异无统计学意义(P>0.05),观察组临床疗效分级更优(P<0.05)。灌洗治疗后7 d,两组肺功能指标PEF、FEV_(1)、FVC及FEV_(1)/FVC均较治疗前上升(P<0.05),且观察组较对照组更高(P<0.05)。灌洗治疗后7 d,两组血清炎症指标CRP、IL-6及PCT均较治疗前下降(P<0.05),且观察组较对照组更低(P<0.05)。观察组退热时间、咳嗽咳痰缓解时间、肺部湿啰音消失时间及住院时间均短于对照组(P<0.05)。两组均未出现严重并发症,两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论对大叶性肺炎患儿实施乙酰半胱氨酸溶液经支气管镜灌洗治疗临床疗效显著,患儿肺功能、血清炎症指标及临床症状明显改善,且临床用药安全。
Objective To investigate the efficacy of acetylcysteine solution in the treatment of lobar pneumonia in children by bronchoscopy and its effect on lung function and serum inflammatory indexes.Methods From September 2020 to August 2023,90 children with lobar pneumonia treated in our hospital were selected as the research objects.The patients were randomly divided into two groups by random number table method.Both groups were given routine anti-infection and symptomatic treatment.On the basis of routine treatment,the control group was treated with normal saline through fiberoptic bronchoscopy alveolar lavage,and the observation group was treated with acetylcysteine solution through bronchoscopy lavage on the basis of routine treatment.The clinical efficacy of the two groups was evaluated 7 days after lavage treatment.The changes of pulmonary function[maximum expiratory flow(PEF),forced expiratory volume in the first second(FEV_(1)),forced vital capacity(FVC)and FEV_(1)/FVC ratio],serum inflammatory indexes[C-reactive protein(CRP),interleukin-6(IL-6)and procalcitonin(PCT)]before treatment and 7 days after lavage treatment were compared between the two groups.The improvement time of clinical symptoms and adverse reactions during treatment were observed in the two groups.Results Compared with the control group,the total effective rate of the observation group was higher,but there was no statistical difference(P>0.05).The clinical efficacy grading of the observation group was better comparing with the control group(P<0.05).After 7 days of lavage treatment,the lung function indexes PEF,FEV_(1),FVC and FEV_(1)/FVC in the two groups increased compared to before treatment(P<0.05),and those in the observation group were higher(P<0.05).After 7 days of lavage treatment,the serum inflammatory indexes CRP,IL-6 and PCT in the two groups decreased compared to before treatment(P<0.05),and those in the observation group were lower(P<0.05).The time of fever,cough and expectoration relief,lung moist rale disappearance and hospitaliza
作者
唐伟伟
阮琰
陈芬
TANG Weiwei;RUAN Yan;CHEN Fen(Department of Pediatrics,Fuzhou Pulmonary Hospital,Fuzhou 350000,China)
出处
《中国医药指南》
2024年第27期79-82,共4页
Guide of China Medicine
基金
福州市科学技术计划项目(2020-WS-113)。
关键词
大叶性肺炎
支气管镜肺泡灌洗
乙酰半胱氨酸
肺功能
炎症指标
Acetylcysteine
Bronchoscopic alveolar lavage
Children with lobar pneumonia
Lung function
Inflammation indicators
