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目的观察机械通气联合异丙托溴铵、布地奈德混悬液雾化吸入治疗儿童重症肺炎并脓毒症的临床疗效。方法选择重症肺炎并发脓毒症的患儿62例为研究对象,按随机数字表分为观察组31例和对照组31例.两组患儿均进行抗感染、抗炎、祛痰、镇静等常规综合治疗。对照组再给予机械通气治疗;观察组在对照组的基础上,再雾化吸入异丙托溴铵、布地奈德混悬液,两组均治疗1周。记录呼吸机使用时间、喉头水肿持续时间,观察治疗前后血气指标PaO_2、PaCO_2变化情况,比较器官功能衰竭的发生率及好转治愈率差异。结果观察组呼吸机使用时间、喉头水肿持续时间明显短于对照组,差异有统计学意义(P<0.05)。观察组和对照组治疗后PaO_2均较治疗前明显升高,PaCO_2较治疗前明显降低,治疗后观察组PaO_2明显高于对照组,PaCO_2明显低于对照组,差异均有统计学意义(P<0.05)。观察组多器官功能衰竭的发生率明显低于对照组,好转治愈率明显高于对照组,差异有统计学意义(P<0.05)。结论机械通气联合雾化吸入在重症肺炎并脓毒症的临床疗效确切,改善疾病转归,值得临床推广使用。
Objective To observe the clinical efficacy of mechanical ventilation combined with ipratropium bromide and budesonide suspension for the treatment of severe pneumonia and sepsis in children. Methods Sixty-two children with severe pneumonia complicated with sepsis were selected as study object, divided into observation group (n = 31) and control group (n = 31) according to random number table.The children in both groups had anti-infection, anti-inflammatory, expectorant and sedation General treatment. The control group was treated with mechanical ventilation again. The observation group was treated with inhalation of ipratropium bromide and budesonide suspension again on the basis of the control group. Both groups were treated for one week. The duration of laryngeal edema and the duration of laryngeal edema were recorded. The changes of PaO_2 and PaCO_2 before and after treatment were observed. The differences of organ failure and improvement of cure rate were compared. Results The duration of ventilator and duration of laryngeal edema in observation group were significantly shorter than those in control group (P <0.05). The PaO 2 in observation group and control group were significantly higher than those before treatment, PaCO 2 was significantly lower than that before treatment, PaO 2 in observation group was significantly higher than that in control group, PaCO 2 was significantly lower than that in control group after treatment (P < 0.05). The incidence of multiple organ failure in the observation group was significantly lower than that in the control group, and the cure rate of improvement was significantly higher than that of the control group (P <0.05). Conclusion Mechanical ventilation combined with inhalation of pneumonia in severe pneumonia and sepsis clinical curative effect is exact, to improve the prognosis of disease, it is worth to promote clinical use.