头孢菌素类药物序贯疗法治疗新生儿肺炎的应用研究

doi:10.3760/cma.j.issn.1007-1245.2023.23.013

摘要/Abstract

摘要：

目的　观察头孢菌素类药物序贯疗法治疗新生儿肺炎的效果及安全性。方法　本文为前瞻性研究。选取2021年1月至2023年1月南阳市中心医院收治的100例新生肺炎患儿为研究对象，采用随机数字表法分为序贯组和常规组，各50例。常规组男32例、女18例，日龄（19.33±5.25）d，予以常规药物治疗；序贯组男30例、女20例，日龄（19.16±5.48）d，予以头孢菌素类药物序贯疗法治疗。对比两组患儿治疗前后炎症因子变化情况，治疗后康复情况、医疗成本及用药安全性。采用t检验、χ²检验。结果　治疗前，两组患儿炎症因子比较，差异均无统计学意义（均P>0.05）；治疗后，序贯组C-反应蛋白（CRP）［（6.65±2.33）mg/L］、白细胞介素-6（IL-6）［（133.65±20.74）ng/L］、降钙素原（PCT）［（0.41±0.15）μg/L］均低于常规组［（7.95±2.12）mg/L、（145.77±20.61）ng/L、（0.73±0.21）μg/L］，差异均有统计学意义（t=2.918、2.931、8.768，均P<0.05）。序贯组咳嗽消失时间［（10.24±3.25）d］、吸气三凹征消失时间［（7.67±2.46）d］、退热时间［（3.11±0.74）d］均短于常规组［（12.77±2.28）d、（8.85±2.14）d、（4.25±1.71）d］，细菌清除率［92.00%（46/50）］高于常规组［76.00%（38/50）］，差异均有统计学意义（t=4.506、2.559、4.326，χ²=4.762；均P<0.05）。序贯组住院时间［（12.23±4.14）d］、总治疗时长［（20.27±5.11）d］均短于常规组［（15.22±5.27）d、（23.11±5.16）d］，总医疗支出［（23.35±5.17）百元］低于常规组［（26.72±5.31）百元］，差异均有统计学意义（t=3.155、2.765、3.215，均P<0.05）。序贯组药物不良反应发生率［10.00%（5/50）］低于常规组［30.00%（15/50）］，差异有统计学意义（χ²=6.250，P=0.012）。结论　头孢菌素类药物序贯治疗新生儿肺炎能有效抑制患儿炎症因子水平并加快康复进程，对缩短患儿治疗周期、降低医疗成本并降低药物不良反应发生风险均有积极意义。

关键词:

新生儿肺炎, 头孢菌素类, 序贯疗法, 炎症因子, 康复进程, 用药安全性

Abstract:

Objective　To observe the efficacy and safety of sequential therapy of cephalosporins in the treatment of neonatal pneumonia. Methods　This was a prospective cohort study. A total of 100 neonatal pneumonia admitted to Nanyang Central Hospital from January 2021 to January 2023 were selected as the study objects, and were divided into a sequential group and a routine group by the random number table method, with 50 cases in each group. In the routine group, there were 32 boys and 18 girls, aged (19.33±5.25) d. In the sequential group, there were 30 boys and 20 girls, aged (19.16±5.48) d. The routine group was treated with routine drugs, and the sequential group was given sequential therapy of cephalosporins. The changes in inflammatory factors before and after treatment, post-treatment recovery, medical costs, and medication safety were compared between the two groups. t test and χ² test were used. Results　Before treatment, there were no statistically significant differences in the inflammatory factors between the two groups (all P>0.05). After treatment, the levels of C-reactive protein (CRP) [(6.65±2.33) mg/L], interleukin-6 (IL-6) [(133.65±20.74) ng/L], and procalcitonin (PCT) [(0.41±0.15) μg/L] in the sequential group were lower than those in the routine group [(7.95±2.12) mg/L, (145.77±20.61) ng/L, and (0.73±0.21) μg/L], with statistically significant differences (t=2.918, 2.931, and 8.768; all P<0.05). Under different treatment regimens, the disappearance time of cough [(10.24±3.25) d], the disappearance time of inspiratory triple concave sign [(7.67±2.46) d], and the fever reduction time [(3.11±0.74) d] in the sequential group were shorter than those in the routine group [(12.77±2.28) d, (8.85±2.14) d, and (4.25±1.71) d], and the bacterial clearance rate [92.00% (46/50)] was higher than that in the routine group [76.00% (38/50)], with statistically significant differences (t=4.506, 2.559, and 4.326, χ²=4.762; all P<0.05). The duration of hospitalization [(12.23±4.14) d] and the total duration of treatment [(20.27±5.11) d] in the sequential group were shorter than those in the routine group [(15.22±5.27) d and (23.11±5.16) d], and the total medical expense [(23.35±5.17) hundred yuan] was lower than that in the routine group [(26.72±5.31) hundred yuan], with statistically significant differences (t=3.155, 2.765, and 3.215; all P<0.05). Under different treatment regimens, the incidence of adverse drug reactions in the sequential group [10.00% (5/50)] was lower than that in the routine group [30.00% (15/50)], with a statistically significant difference (χ²=6.250, P=0.012). Conclusion　Sequential therapy of cephalosporins in the treatment of neonatal pneumonia can effectively inhibit the levels of inflammatory factors in children and accelerate the rehabilitation process, which has positive significance in shortening the children's treatment cycle, reducing the medical costs, and reducing the risk of adverse drug reactions.

Key words:

Neonatal pneumonia, Cephalosporins, Sequential therapy, Inflammatory factors, Rehabilitation process, Medication safety

何青田静.

头孢菌素类药物序贯疗法治疗新生儿肺炎的应用研究 [J]. 国际医药卫生导报, 2023, 29(23): 3379-3382.

He Qing, Tian Jing.

Application of sequential therapy of cephalosporins in the treatment of neonatal pneumonia [J]. International Medicine and Health Guidance News, 2023, 29(23): 3379-3382.

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