【摘要】 目的观察高渗盐水联合布地奈德雾化吸入佐治新生儿支气管炎、肺炎等肺部感染的临床效果,为临床提供参考。方法选择2015年10月-2016年12月涪陵区妇幼保健院接受治疗的110例肺部感染新生儿为研究对象,随机分为观察组和对照组,每组各55例。对照组予以祛痰、平喘、补液等治疗,必要时予以退热、抗感染治疗。观察组在此基础上予以高渗生理盐水联合布地奈德雾化吸入:布地奈德混悬液1 ml+3%生理盐水2 ml。比较两组新生儿的临床疗效,主要症状消退时间,动脉氧气分压（PaO₂）、二氧化碳分压（PaCO₂）、血氧饱和度（SpO₂）、白细胞介素-4（IL-4）、白细胞介素-10（IL-10）、白细胞介素-12（IL-12）和干扰素-γ（IFN-γ）水平。结果观察组临床疗效优于对照组（P<0.05）,新生儿喘憋、气促、咳嗽、肺部喘鸣音、湿性啰音等主要症状消退时间短于对照组（P<0.05）。治疗前,两组新生儿PaO₂、PaCO₂、SpO₂、IL-4、IL-10、IL-12和IFN-γ比较,差异无统计学意义（P>0.05）。治疗后,观察组PaO₂、SpO₂、IL-12和IFN-γ高于对照组（P<0.05）,而PaCO₂、IL-4和IL-10低于对照组（P<0.05）。两组不良反应发生率比较,差异无统计学意义（P>0.05）。结论 3%高渗生理盐水联合布地奈德雾化吸入佐治新生儿肺部感染的疗效确切,可有效缩短临床症状消退时间,改善血气指标,纠正Th1/Th2免疫应答失衡,且不增加不良反应。更多还原

【Abstract】 Objective To observe the clinical effect of hypertonic saline combined with atomization inhalation of budesonide in treatment of pulmonary infection（ neonatal bronchitis,pneumonia） in neonates,provide a reference for clinical treatment. Methods From October 2015 to December 2016,110 neonates with pulmonary infection treated in Maternal and Child Health Care Hospital of Fuling District were selected and randomly divided into observation group and control group,55 neonates in each group. The neonates in control group were treated with eliminating phlegm,relieving asthma,and fluid replacement,anti-pyretic and anti-infective treatment if necessary. The neonates in observation group were treated with hypertonic saline combined with atomization inhalation of budesonide（ budesonide suspension1 ml+3% hypertonic saline 2 ml） based on the routine therapy used in control group. The clinical effects,remission time of main symptoms,arterial oxygen partial pressure（ PaO₂）,partial pressure of carbon dioxide（ PaCO₂）,oxygen saturation（ SpO₂）,interleukin-4（ IL-4）,interleukin-10（ IL-10）,interleukin-12（ IL-12）,and interferon-γ（ IFN-γ） levels in the two groups were compared. Results The clinical efficacy in observation group was statistically significantly better than that in control group（ P<0. 05）. The remission time of neonatal main symptoms（ wheezing,shortness of breath,coughing,pulmonary wheezing,wet rales） in observation group was statistically significantly shorter than that in control group（ P<0. 05）. Before treatment,there was no statistically significant difference in PaO₂,PaCO₂,SpO₂,IL-4,IL-10,IL-12,and IFN-γ levels between the two groups（ P>0. 05）. After treatment,PaO₂,SpO₂,IL-12,and IFN-γlevels in observation group were statistically significantly higher than those in control group（ P< 0. 05）,while PaCO₂,IL-4,and IL-10 levels in observation group were statistically significantly lower than those in control group（ P< 0. 05）. There was no statistically significant difference in the incidence rate of adverse reactions between the two groups（ P>0. 05）. Conclusion The curative effect of hypertonic saline（ 3%） combined with atomization inhalation of budesonide in treatment of pulmonary infection in neonates is good,the therapy can effectively shorten the remission time of clinical symptoms,improve blood gas indexes,correct the imbalance of Th1/Th2 immune response,and it can not increase adverse reactions.更多还原