无创吸痰结合乙酰半胱氨酸治疗小儿支气管肺炎的效果分析

doi:10.3760/cma.j.issn.1007-1245.2023.19.006

摘要/Abstract

摘要：

目的　观察无创吸痰法结合乙酰半胱氨酸治疗小儿支气管肺炎的效果及对改善临床症状、炎性反应的影响。方法　本次研究选择2021年1月至2022年6月期间南阳医学高等专科学校第一附属医院收治的136例支气管肺炎患儿作为研究对象，通过抽签法将入组患儿随机分为两组，每组68例。对照组中男35例，女33例，年龄（4.96±1.05）岁，病程（1.45±0.21）d，予以常规治疗+雾化吸入乙酰半胱氨酸治疗；观察组中男38例，女30例，年龄（4.24±1.36）岁，病程（1.57±0.45）d，实施无创吸痰法配合常规治疗+雾化吸入乙酰半胱氨酸治疗。比较两组患儿症状改善情况、炎性反应、肺动脉血气及免疫功能。采用独立样本t检验、χ²检验。结果　治疗前，两组患儿的炎性指标、动脉血气指标以及免疫功能指标差异均无统计学意义（均P>0.05）。治疗后，观察组的止咳时间、退热时间、肺部啰音消失时间、憋喘消失时间分别为（5.24±1.23）d、（1.45±0.27）d、（4.24±1.25）d、（1.88±0.27）d，均短于对照组的（6.77±1.36）d、（2.06±0.77）d、（5.37±1.82）d、（2.46±0.85）d，差异均有统计学意义（t=6.880、6.165、4.220、5.363，均P<0.001）；治疗后，观察组的C-反应蛋白、白细胞介素-6、降钙素原、动脉氧分压、血氧饱和度、二氧化碳分压分别为（7.44±2.32）mg/L、（112.25±20.18）ng/L、（0.82±0.23）µg/L、（70.25±10.44）mmHg（1 mmHg=0.133 kPa）、（95.77±5.36）%、（45.25±10.33）mmHg，对照组分别为（9.15±2.48）mg/L、（127.42±20.62）ng/L、（1.16±0.47）µg/L、（64.41±10.82）mmHg、（92.31±5.11）%、（51.77±10.46）mmHg，差异均有统计学意义（t=4.152、4.336、5.358、3.287、3.853、3.657，均P<0.001）；治疗后，观察组的免疫球蛋白E（IgE）、IgG、呼吸频率分别为（62.35±10.33）g/L、（14.35±5.14）g/L、（22.37±2.49）次/min，对照组为（71.34±10.25）g/L、（17.27±5.17）g/L、（24.48±2.16）次/min，差异均有统计学意义（t=5.094、3.303、5.279，均P<0.05）。结论　无创吸痰法配合雾化吸入乙酰半胱氨酸可促进患儿症状恢复，对改善患儿炎性反应、动脉血气指标及免疫功能均有积极意义。

关键词:

支气管肺炎, 小儿, 乙酰半胱氨酸, 无创吸痰法, 炎性反应, 临床症状

Abstract:

To observe the effect of noninvasive sputum aspiration combined with acetylcysteine on children with bronchopneumonia and its effect in improving clinical symptoms and inflammation. Methods　In this study, 136 children with bronchopneumonia admitted to the First Affiliated Hospital of Nanyang Medical College from January 2021 to June 2022 were selected as the research objects, and they were randomly divided into two groups by lottery, 68 cases in each group. In the control group, 35 boys and 33 girls, aged (4.96±1.05) years, with a duration of disease of (1.45±0.21) d, were treated with conventional treatment plus aerosol inhalation of acetylcysteine. In the observation group, 38 boys and 30 girls, aged (4.24±1.36) years, with a duration of disease of (1.57±0.45) d, were treated with noninvasive sputum aspiration combined with conventional treatment and aerosol inhalation of acetylcysteine. The symptom improvement, inflammation, pulmonary arterial blood gas, and immunity were compared between the two groups. Independent sample t test and χ² test were used. Results　Before treatment, there were no statistically significant differences in the inflammatory indexes, arterial blood gas indexes, and immune function indexes between the two groups (all P>0.05). After treatment, the cough relief time, fever remission time, lung rale disappearance time, and asthma disappearance time of the observation group were (5.24±1.23) d, (1.45±0.27) d, (4.24±1.25) d, and (1.88±0.27) d, respectively, which were shorter than (6.77±1.36) d, (2.06±0.77) d, (5.37±1.82) d, and (2.46±0.85) d in the control group, with statistically significant differences (t=6.880, 6.165, 4.220, and 5.363; all P<0.001). After treatment, the C-reactive protein, interleukin-6, procalcitonin, arterial partial pressure of oxygen, blood oxygen saturation, and partial pressure of carbon dioxide in the observation group were (7.44±2.32) mg/L, (112.25±20.18) ng/L, (0.82±0.23) µg/L, (70.25±10.44) mmHg (1 mmHg = 0.133 kPa), (95.77±5.36)%, (45.25±10.33) mmHg, and those in the control group were (9.15±2.48) mg/L, (127.42±20.62) ng/L, (1.16±0.47) µg/L, (64.41±10.82) mmHg, (92.31±5.11)%, and (51.77±10.46) mmHg, with statistically significant differences (t=4.152, 4.336, 5.358, 3.287, 3.853, and 3.657; all P<0.001). After treatment, the immunoglobulin E (IgE), IgG, and respiratory rate of the observation group were (62.35±10.33) g/L, (14.35±5.14) g/L, and (22.37±2.49) times/min, those in the control group were (71.34±10.25) g/L, (17.27±5.17) g/L, and (24.48±2.16) times/min, with statistically significant differences (t=5.094, 3.303, and 5.279; all P<0.05). Conclusion　Noninvasive sputum aspiration combined with aerosol inhalation of acetylcysteine can promote the recovery of symptoms in children, and has positive significance in improving the inflammatory response, arterial blood gas indexes, and immunity.

Key words:

Bronchopneumonia, Children, Acetylcysteine, Noninvasive sputum aspiration, Inflammatory reaction, Clinical symptoms

周冉冉蒲海波王媛.

无创吸痰结合乙酰半胱氨酸治疗小儿支气管肺炎的效果分析 [J]. 国际医药卫生导报, 2023, 29(19): 2688-2692.

Zhou Ranran, Pu Haibo, Wang Yuan.

Analysis of the effect of non-invasive sputum aspiration combined with acetylcysteine on children with bronchopneumonia [J]. International Medicine and Health Guidance News, 2023, 29(19): 2688-2692.

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