张亚维+康文清+熊虹+许邦礼+张耀东+李朝晖+王颍源+刘大鹏+郑丽娟

[摘要]目的 探讨在新生儿重症肺炎及其并发症的治疗中使用静脉用丙种球蛋白（IVIG）的临床效果。方法 选取2012年5月～2014年5月我院收治的160例新生儿重症肺炎患儿的临床资料进行回顾性分析，依据是否给予IVIG治疗分为IVIG组（81例）与对照组（79例）。比较两组患儿的临床疗效、呼吸困难缓解时间、住院时间、机械通气时间及并发症的发生情况。结果 与对照组比较，IVIG组患儿的呼吸困难缓解时间、住院时间及机械通气时间均显著缩短，有效率明显升高，差异有统计学意义（P<0.05）。与对照组比较，观察组患儿胸腔积液和肺不张的发生率显著降低，差异有统计学意义（P<0.05）；两组患儿呼吸衰竭、肝功能损害的发生率比较，差异无统计学意义（P>0.05）。結论 IVIG辅助治疗新生儿重症肺炎效果确切，且能减少并发症。

[关键词]静脉用丙种球蛋白；重症肺炎；新生儿；并发症

[中图分类号] R725.6 [文献标识码] A [文章编号] 1674-4721（2017）01（c）-0089-03

[Abstract]Objective To discuss the clinical effect of intravenous immunoglobulin （IVIG） in the treatment of severe neonatal pneumonia and complications.Methods Clinical data of 160 hospitalized newborn with severe pneumonia in our hospital from May 2012 to May 2014 were retrospectively analyzed.Patients were divided into IVIG group （81 cases） and control group （79 cases）.The therapeutic effects，dyspnea time，length of stay in hospital，duration of mechanical ventilation，and complications between the two groups were compared.Results Compared with the control group，the dyspnea time，duration of hospital stay and mechanical ventilation time were significantly shorter，the effective rate was improved in the IVIG group，the differences were statistically significant （P<0.05）.The incidence of pleural effusion and atelectasis were obviously lower in the IVIG group than that in the control group，the difference was statistically significant （P<0.05）.There was no significant difference in respiratory failure and hepatic function damage between the two groups （P>0.05）.Conclusion IVIG is effective in the treatment of severe neonatal pneumonia，and with few complications.

[Key words]Intravenous immunoglobulin；Severe pneumonia；Newborn；Complications

新生儿肺炎是新生儿期常见的疾病，可由多种病原体感染所致，由于新生儿各系统发育不完全，免疫功能不成熟，肺部感染时易进展为重症肺炎，以伴有发热、呼吸困难等弥漫性肺部病变及不典型的临床表现为特点，病情重、进展快、病死率高。因此，在临床上如何更好地遏止肺部病变的进行性发展，避免多脏器功能衰竭，改善预后，降低新生儿重症肺炎的死亡率，一直是新生儿科医生研究重点。近年来，关于静脉用丙种球蛋白（intravenous immunoglobulin，IVIG）用于治疗重症肺炎研究较多，且均取得较好的临床疗效[1-3]，但关于IVIG用于治疗新生儿重症肺炎的研究相对较少。本研究回顾性分析我院160例重症肺炎新生儿的治疗及预后情况，探讨IVIG对新生儿重症肺炎的辅助治疗效果。……