姚晓燕 丁武君 杨戎威 朱玲仙

[摘要] 目的 探討支气管镜肺泡灌洗术联合局部注入乙酰半胱氨酸或者盐酸氨溴索治疗新生儿重症肺炎的效果。 方法 选取2016年1月～2017年12月入住嘉兴市妇幼保健院的新生儿重症肺炎患者为研究对象，根据随机数字表法将其分为研究组和对照组，每组38例患儿。研究组接受支气管肺泡灌洗术联合局部注入乙酰半胱氨酸治疗，对照组采用支气管肺泡灌洗术联合局部注入盐酸氨溴索治疗。比较两组患儿体温恢复时间、肺部啰音消失时间、影像恢复时间及住院天数以及不良反应发生情况，评价支气管镜肺泡灌洗术联合乙酰半胱氨酸或盐酸氨溴索在新生儿重症肺炎中的治疗效果。 结果 体温恢复、肺部啰音消失、影像恢复时间及住院天数，研究组均短于对照组，差异有统计学意义（P < 0.05）；两组总疗效、不良反应发生率比较，差异无统计学意义（P < 0.05）。 结论 支气管肺泡灌洗联合局部注入乙酰半胱氨酸或盐酸氨溴索对新生儿重症肺炎疗效好，安全性高，但局部注入乙酰半胱氨酸较盐酸氨溴索的更能缩短病程，使患儿尽快康复，此方法值得临床推广。

[关键词] 支气管镜肺泡灌洗术；新生儿重症肺炎；乙酰半胱氨酸；盐酸氨溴索

[中图分类号] R725.6 [文献标识码] A [文章编号] 1673-7210（2018）04（c）-0090-04

The effect of bronchoscopic alveolar lavage combined with local injection of Acetylcysteine or Ambroxol Hydrochloride in the treatment of neonatal severe pneumonia

YAO Xiaoyan1 DING Wujun2 YANG Longwei2 ZHU Lingxian1

1.Department of Pharmacy， Jiaxing Maternal and Children Care Service Hospital， Zhejiang Province， Jiaxing 314051， China 2.Department of Pediatrics， Jiaxing Maternal and Children Care Service Hospital， Zhejiang Province， Jiaxing 314051， China

[Abstract] Objective To explore the effect of bronchoscopic alveolar lavage combined with local injection of Acetylcysteine or Ambroxol Hydrochloride in the treatment of neonatal severe pneumonia. Methods The children of neonatal severe pneumonia were selected in the Jiaxing Maternal and Children Care Service Hospital from January 2016 to December 2017， and they were divided into control group and treatment group according to randon number table， with each group of 38 cases. Treatment group received bronchoalveolar lavage surgery combined therapy with local injection of Acetylcysteine， and control group received bronchoalveolar lavage surgery combined therapy with local injection of Ambroxol Hydrochloride. The above-mentioned children of two groups were compared with body temperature， moist rales， imageology， length of hospital stay and adverse reactions to evaluate the therapeutic effect of bronchoscope alveolar lavage operation combined Acetylcysteine or Ambroxol Hydrochloride in neonatal severe pneumonia. Results Between the two groups， there were significant differences in the recovery time of temperaturet， moist rales， imageology and length of stay， which were all shorter in the treatment group （P < 0. 05）. Otherwise， no significant difference was found in the curative effect and incidence of adverse reactions between the treatment and control group （P > 0.05）. Conclusion Bronchoscopic alveolar lavage combined with local injection of Acetylcysteine or Ambroxol Hydrochloride is effective and safe in the treatment of neonatal severe pneumonia. Local injection of Acetylcysteine can shorten the course of disease compared with Ambroxol Hydrochloride， making children recover as soon as possible. In a word， this method is worthy of clinical promotion.

[Key words] Bronchoscopic alveolar lavage； Neonatal severe pneumonia； Acetylcysteine； Ambroxol Hydrochloride

新生儿重症肺炎为严重的呼吸系统疾病，致残率、致死率高[1]。支气管镜肺泡灌洗术因其疗效肯定，并发症少现已广泛用于肺部感染特别是重症患者，而且可局部用药，使局部药物浓度增加，疗效大幅度提高[2]。由于新生儿生理解剖特点，排痰较差，而痰液淤滞会使细菌繁殖增加，感染难以有效控制，故祛痰也非常关键。本研究在临床常规治疗基础上使用支气管镜进行支气管肺泡灌洗，并联合局部注入乙酰半胱氨酸……