摘要
目的探讨雾化吸入布地奈德、特布他林结合机械辅助排痰治疗重症肺炎患儿的疗效,并探讨其护理措施。方法选择重症肺炎患儿80例作为研究对象,随机分为对照组和观察组,每组40例。2组患儿均给予退热、止咳、平喘、抗生素和抗病毒等常规治疗措施和护理,观察组在常规治疗基础上雾化吸入布地奈德、特布他林结合机械辅助排痰治疗,并给予针对性护理措施。观察2组临床疗效、症状缓解时间及治疗前后心功能指标[左心室射血分数(LVEF)、左心室收缩末期内径(LVDD)、房室瓣E与A峰比值(E/A)、心指数(CI)]、肺功能指标[肺活量(FVC)、最大呼气第1秒容积(FEV1)、峰值呼气流速(PEF)]、白细胞计数(WBC)、降钙素原(PCT)、血清炎性因子[白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)]变化。结果观察组总有效率明显高于对照组,症状缓解时间明显短于对照组,差异有统计学意义(P<0.05)。2组治疗前LVEF、LVDD、E/A、CI、FVC、FEV1、PEF、WBC、PCT、IL-6、TNF-α、CRP比较差异无统计学意义(P>0.05)。2组治疗后LVEF、E/A、CI、FVC、FEV1、PEF明显高于治疗前,LVDD、WBC、PCT、IL-6、TNF-α、CRP明显低于治疗前(P<0.05),且观察组LVEF、E/A、CI、FVC、FEV1、PEF高于对照组,LVDD、WBC、PCT、IL-6、TNF-α、CRP低于对照组,差异有统计学意义(P<0.05)。结论雾化吸入布地奈德、特布他林结合机械辅助排痰治疗重症肺炎患儿,并给予针对性护理措施,临床疗效显著,能够缩短症状缓解时间,增强心肺功能及降低血清炎性因子水平。
Objective To observe the therapeutic effects of atomization inhalation of terbutaline and budesonide combined with mechanical assisted expectoration on severe pneumonia in children,and to explore its nursing intervention.Methods A total of 80 children patients with severe pneumonia who were treated in our hospital from January 2016 to January 2018 were randomly divided into control group(n=40) and observation group(n=40). The patients in both groups were given conventional therapy including pyretolysis, cough relieving, antibiotics and antiviral drugs,moreover,the patients in observation group were treated by atomization inhalation of terbutaline and budesonide combined with mechanical assisted expectoration,with directive nursing intervention. The clinical curative effects,symptoms disappearance time,and the changes of heart function indexes(LVEF, LVDD, E/A,CI),pulmonary function indexes(FVC,FEV1,PEF),WBC,PCT,serum levels of inflammatory cytokines including IL-6,TNF-α,CRP were observed and compared between the two groups.Results The total effective rate in observation group was significantly higher than that in control group,and symptoms disappearance time was significantly shorter than that in control group(P<0.05).Before treatment there were no significant differences in the levels of LVEF,LVDD,E/A,CI,FVC,FEV1,PEF,WBC,PCT,IL-6,TNF-α,CRP between the two groups(P>0.05). After treatment the levels of LVEF,E/A,CI,FVC,FEV1,PEF in both groups were significantly higher than those before treatment,however,the levels of LVDD,WBC,PCT,IL-6,TNF-α,CRP in both two groups were significantly lower than those before the treatment(P<0.05).Moreover the improvement extent in observation group was more significant than that in control group(P<0.05).Conclusion The atomization inhalation of terbutaline and budesonide combined with mechanical assisted expectoration as well as directive nursing intervention can ontain significant therapeutic effects on severe pneumonia in children,which can shorten symptomatic relief time,strengthen the heart and pulmonary function,and reduce the serum levels of inflammatory factors significantly.
引文
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