【摘要】 目的:探讨乙酰半胱氨酸(acetylcysteine,NAC)雾化联合纤支镜局部用药治疗儿童机械通气重症肺炎临床疗效及安全性。方法:将机械通气重症肺炎患儿82例分为对照组(氨溴索组)和观察组(乙酰半胱氨酸组)各41例;在常规治疗基础上,对照组采用盐酸氨溴索雾化联合纤支镜肺泡灌洗+局部用药治疗;观察组采用NAC雾化联合纤支镜灌洗+局部用药治疗;比较两组患儿治疗效果及预后及不良反应情况。结果:观察组治疗有效率高于对照组(P<0.05),机械通气时间及重症监护时间均短于对照组(P<0.05);14 d死亡率、不良反应两组间比较差异无统计学意义(P>0.05)。结论:NAC联合纤支镜治疗儿童机械通气重症肺炎,能有效改善呼吸功能,缩短有创通气时间和重症监护时间,安全有效。更多还原

【Abstract】 Objective: To investigate the clinical efficacy and safety of acetylcysteine atomization combined with bronchoscopy in the treatment of children with severe pneumonia and mechanical ventilation. Methods: 82 Children with severe pneumonia and mechanical ventilation were randomly divided into the control group( the ambroxol group) and the observation group( the acetylcysteine group),41 cases in each group. On the basis of conventional treatment,the patients in the control group received ambroxol hydrochloride atomization,bronchoalveolar lavage with bronchoscopy and topical treatment,while the patients in the observation group were treated with N-Acetylcysteine( NAC) atomization combined with bronchofiberscopic lavage and topical treatment. The therapeutic effect,prognosis and adverse reaction of the two groups were compared. Results:the treatment efficiency of the observation group was higher than that of the control group( P < 0. 05),and the mechanical ventilation time and the intensive care time were shorter than those of the control group( P < 0. 05). There was no statistically significant difference in the mortality rate and the adverse reaction rate in 14 d between the two groups( P > 0. 05). Conclusion: For the treatment of children with severe pneumonia and mechanical ventilation,acetylcysteine combined with bronchoscopy can effectively improve respiratory function,shorten invasive ventilatory time and the time of intensive care,and be safe and effective.更多还原