N-乙酰半胱氨酸雾化吸入辅助治疗新生儿肺炎的疗效分析
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摘要
目的探讨雾化吸入N-乙酰半胱氨酸辅助治疗新生儿肺炎的临床效果。方法选取2016年1月～2017年1月抚顺矿务局总医院新生儿病房收治的196例新生儿肺炎患儿为研究对象,按照随机数字表法分为观察组98例与对照组98例,两组均给予常规抗感染,止咳平喘治疗,必要时吸痰,营养支持等综合治疗。观察组加用N-乙酰半胱氨酸雾化吸入。比较两组疗效,观察两组患者咳嗽、肺部啰音消失时间及平均住院时间,比较治疗前后两组WBC、CRP、PCT、PaCO_2指标变化情况。结果治疗后两组患儿WBC、CRP、PCT、PaCO_2水平均较治疗前显著下降,差异有统计学意义(P<0.05)。观察组治疗后PaCO_2水平低于对照组,差异有统计学意义(P<0.05)。观察组患儿咳嗽、肺部湿罗音消失时间、住院时间均显著低于对照组(P<0.05)。观察组总有效率(95.92%)高于对照组(87.76%),临床疗效优于对照组,差异有统计学意义(P<0.05)。结论 N-乙酰半胱氨酸雾化辅助治疗新生儿肺炎能提高治愈率,缩短病程,值得临床推广应用。
Objective To investigate the clinical effect of N-acetylcysteine aerosol inhalation in the adjuvant treatment of neonatal pneumonia. Methods A total of 196 children with neonatal pneumonia admitted in the neonatal ward of Fushun Mining Bureau General Hospital from January 2016 to January 2017 were selected as subjects. According to the random number table method, the patients were divided into observation group(n=98) and control group(n=98). Both groups were given conventional anti-infective, cough and asthma, if necessary, sucking, nutritional support and other comprehensive treatment. The observation group was added with N-acetylcysteine aerosol inhalation. The curative effect of the two groups was compared. The cough, the disappearance time of the lungs and the average hospital stay between two groups were observed. The changes of WBC, CRP, PCT and PaCO_2 between two groups were compared before and after treatment. Results The levels of WBC, CRP, PCT and PaCO_2 in the two groups after treatment were significantly lower than those before treatment, and the difference was statistically significant(P<0.05). The level of PaCO_2 in the observation group was lower than that in the control group after treatment,and the difference was statistically significant(P<0.05). The cough, the disappearance of the wet rales in the lungs, and hospital stay of the children in the observation group were significantly lower than those in the control group(P<0.05). The total effective rate of the observation group(95.92%) was higher than that of the control group(87.76%), and the clinical efficacy was better than that of the control group. The difference was statistically significant(P<0.05). Conclusion N-acetylcysteine inhalation in the adjuvant treatment of neonatal pneumonia can improve the cure rate and shorten the course of the disease, which is worthy of clinical application.
Objective To investigate the clinical effect of N-acetylcysteine aerosol inhalation in the adjuvant treatment of neonatal pneumonia. Methods A total of 196 children with neonatal pneumonia admitted in the neonatal ward of Fushun Mining Bureau General Hospital from January 2016 to January 2017 were selected as subjects. According to the random number table method, the patients were divided into observation group(n=98) and control group(n=98). Both groups were given conventional anti-infective, cough and asthma, if necessary, sucking, nutritional support and other comprehensive treatment. The observation group was added with N-acetylcysteine aerosol inhalation. The curative effect of the two groups was compared. The cough, the disappearance time of the lungs and the average hospital stay between two groups were observed. The changes of WBC, CRP, PCT and PaCO_2 between two groups were compared before and after treatment. Results The levels of WBC, CRP, PCT and PaCO_2 in the two groups after treatment were significantly lower than those before treatment, and the difference was statistically significant(P<0.05). The level of PaCO_2 in the observation group was lower than that in the control group after treatment,and the difference was statistically significant(P<0.05). The cough, the disappearance of the wet rales in the lungs, and hospital stay of the children in the observation group were significantly lower than those in the control group(P<0.05). The total effective rate of the observation group(95.92%) was higher than that of the control group(87.76%), and the clinical efficacy was better than that of the control group. The difference was statistically significant(P<0.05). Conclusion N-acetylcysteine inhalation in the adjuvant treatment of neonatal pneumonia can improve the cure rate and shorten the course of the disease, which is worthy of clinical application.
引文
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[13]朱卫东,朱翠平,严建江,等.N-乙酰半胱氨酸治疗肺炎患儿全身炎症反应综合征的临床研究[J].热带医学杂志,2010,10(8):952-955.
[14]王龙,王丽娜,张立明,等.N-乙酰半胱氨酸雾化吸入辅助治疗婴幼儿支气管肺炎的疗效分析[J].中国全科医学,2015,18(3):335-338.
[15]夏海玲,李鲜峰,肖芸.N-乙酰半胱氨酸在几种肺部疾病中应用的研究进展[J].中国预防医杂志,2015,16(4):312-317.
[16]Rajamani M,Nagasubramanian V,Ayyavoo A,et al.Surgically induced necrotizing scleritis following strabismus surgery treated successfully with topical n-acetylcysteine in a child with congenital fibrosis of extraocular muscles and Varadi Papp syndrome[J].Strabismus,2017,25(1):39-42.
[17]许国春.肺炎患儿药物治疗前后免疫功能的改变情况[J].中国妇幼保健,2014,29(27):4428-4431.
[18]Tan Y,Wang Y,Li M,et al.Enhanced photoelectrochemical immunosensing of cardiac troponinⅠbased on energy transfer between N-acetyl-L-cysteine capped Cd Ag Te quantum dots and dodecahedral Au nanoparticles[J].Biosens Bioelectron,2017,91:741-746.
[19]Olofsson AC,Hermansson M,Elwing H.N-acetylcysteine affects growth,extracellular polychariden production and bacterial biofilm formation on solid surface[J].Appl Environ Microbiol,2003,69(8):4814-4822.
[20]Marchese A,Bozzolasco M,Gualco L,et a1.Effect of fosfomycin alone and incombination with N-acetylcysteine on E.coli biofilms[J].Int J Antimicrob Agents,2003,22:S95-S100.
[2]晋荣新,鄢毅.N-乙酰半胱氨酸与盐酸氨溴索治疗小儿支气管肺炎的疗效对比及其对免疫功能和临床症状的影响[J].中国妇幼保健,2018,33(1):118-120.
[3]邵肖梅,叶鸿瑁,丘小汕,等.实用新生儿学[M].北京:人民卫生出版社,2011:402-403.
[4]陈彦飞.N-乙酰半胱氨酸雾化吸入对婴幼儿支气管肺炎患儿免疫功能及预后的影响[J].医学综述,2015,21(19):3637-3639.
[5]Rouby JJ,Bouhemad B,Monsel A,et al.Aerosolized antibiotics for ventilator-associated pneumonia:Lessons from experimental studies[J].Anesthesiology,2012,117(6):1364-1380.
[6]廖邦冰,景秀娟.新生儿肺炎给予盐酸氨溴索雾化吸入联合静脉注射的临床观察[J].数理医药学杂志,2016,29(1):29-30.
[7]阳倩,李茂军.盐酸氨溴索雾化吸入辅助治疗新生儿肺炎的临床效果及对动脉血气的影响[J].中国医学前沿杂志:电子版,2016,8(8):96-99.
[8]Chang CT,Korivi M,Huang HC,et al.Inhibition of ROSproduction,autophagy or apoptosis signaling reversed the anticancer properties of Antrodia salmonea in triplenegative breast cancer(MDA-MB-231)cells[J].Food Chem Toxicol,2017,103:1-17.
[9]Bedreag OH,Rogobete AF,Sandesc D,et al.Modulation of the redox expression and inflammation response in the criticallyⅢpolytrauma patient with thoracic injury.Statistical correlations between antioxidant therapy[J].Clin Lab,2016,62(9):1747-1759.
[10]刘晓辉,金妍,邓淑仙,等.乙酰半胱氨酸对慢性阻塞性肺疾病患者呼吸功能及血清细胞因子的影响[J].中国医药科学,2013,3(13):42-43.
[11]肖义峰,潘以韵,王芳.乙酰半胱氨酸雾化吸入治疗小儿支气管肺炎疗效观察[J].临床合理用药杂志,2017,10(34):96-97.
[12]常建刚.N-乙酰半胱氨酸辅助治疗新生儿支气管肺炎疗效及对血清炎性指标的影响[J].中国基层医药,2016,23(1):7-11.
[13]朱卫东,朱翠平,严建江,等.N-乙酰半胱氨酸治疗肺炎患儿全身炎症反应综合征的临床研究[J].热带医学杂志,2010,10(8):952-955.
[14]王龙,王丽娜,张立明,等.N-乙酰半胱氨酸雾化吸入辅助治疗婴幼儿支气管肺炎的疗效分析[J].中国全科医学,2015,18(3):335-338.
[15]夏海玲,李鲜峰,肖芸.N-乙酰半胱氨酸在几种肺部疾病中应用的研究进展[J].中国预防医杂志,2015,16(4):312-317.
[16]Rajamani M,Nagasubramanian V,Ayyavoo A,et al.Surgically induced necrotizing scleritis following strabismus surgery treated successfully with topical n-acetylcysteine in a child with congenital fibrosis of extraocular muscles and Varadi Papp syndrome[J].Strabismus,2017,25(1):39-42.
[17]许国春.肺炎患儿药物治疗前后免疫功能的改变情况[J].中国妇幼保健,2014,29(27):4428-4431.
[18]Tan Y,Wang Y,Li M,et al.Enhanced photoelectrochemical immunosensing of cardiac troponinⅠbased on energy transfer between N-acetyl-L-cysteine capped Cd Ag Te quantum dots and dodecahedral Au nanoparticles[J].Biosens Bioelectron,2017,91:741-746.
[19]Olofsson AC,Hermansson M,Elwing H.N-acetylcysteine affects growth,extracellular polychariden production and bacterial biofilm formation on solid surface[J].Appl Environ Microbiol,2003,69(8):4814-4822.
[20]Marchese A,Bozzolasco M,Gualco L,et a1.Effect of fosfomycin alone and incombination with N-acetylcysteine on E.coli biofilms[J].Int J Antimicrob Agents,2003,22:S95-S100.