童志杰 谢志伟 梁宇峰 许丽珍

摘 要 目的：探讨纤维支气管镜联合盐酸氨溴索治疗小儿重症肺炎合并肺不张的疗效及安全性。方法：选取120例重症肺炎合并肺不张患儿，分为对照组和观察组各60例。对照组给予常规纤维支气管镜灌洗治疗，而观察组另加盐酸氨溴索治疗。分析两组临床总有效率、临床疗效指标、肺功能、血气分析及不良反应情况。结果：观察组临床总有效率和PaO2、PaO2/FiO2、FEV1、FVC、FEV1/FVC水平均高于对照组，而各临床疗效指标和PaCO2、TNF-α、IL-6、hsCRP、PCT水平均低于对照组（P<0.05）；两组均无明显不良反应。结论：纤维支气管镜联合盐酸氨溴索可改善小儿重症肺炎合并肺不张的临床症状，提高患儿肺功能和氧合功能。

关键词 纤维支气管镜 盐酸氨溴索 重症肺炎 肺不张

中图分类号：R974.1； R725.6 文献标志码：A 文章编号：1006-1533（2021）11-0028-05

Efficacy and safety of fiberbronchoscope combined with ambroxol hydrochloride in the treatment of severe pneumonia with atelectasis in children

TONG Zhijie*， XIE Zhiwei， LIANG Yufeng， XU Lizhen

（Department of Respiration， Guangzhou Women and Children Medical Center， Guangzhou 510000， China）

ABSTRACT Objective： To explore the efficacy and safety of fiberbronchoscope combined with ambroxol hydrochloride in the treatment of severe pneumonia with atelectasis in children. Methods： One hundred and twenty children with severe pneumonia and atelectasis were selected and randomly divided into a control group and an observation group with 60 cases each. The control group was treated with conventional fiberbronchoscope lavage while the observation group was additionally treated with ambroxol hydrochloride. The total clinical effective rate， clinical efficacy indexes， pulmonary function， blood gas analysis and adverse reactions in the two groups were analyzed and compared. Results： The total clinical effective rate and the levels of PaO2， PaO2/FiO2， FEV1， FVC， FEV1/FVC were higher while the clinical efficacy indexes and the level of PaCO2， TNF-α， IL-6， hsCRP and PCT were lower in the observation group than the control group （P<0.05）. There were no significant adverse reactions in both groups. Conclusion： Fiberbronchoscope combined with ambroxol hydrochloride for the treatment of severe pneumonia and atelectasis in children can improve their clinical symptoms and lung and oxygenation function.

KEy WORDS fiberbronchoscope； ambroxol hydrochloride； severe pneumonia； atelectasis

重癥肺炎是由病毒、细菌等多种因素所致的呼吸系统常见病，易合并肺不张，严重者可危及患儿生命[1-2]。经纤维支气管镜行支气管肺泡灌洗术是临床常用于治疗重症肺炎合并肺不张的方法，具有较好的临床疗效，但容易出现抗生素耐药等问题，影响患者预后[3-4]。盐酸氨溴索是临床常用于支气管扩张、支气管哮喘、新生儿呼吸窘迫等疾病治疗的药物，可促进肺表面活性物质的合成，提高急、慢性肺部疾病治疗效果[5-6]。目前，关于纤维支气管镜联合盐酸氨溴索治疗小儿重症肺炎合并肺不张的报道较少，且临床尚无系统的治疗方案。本研究以120例小儿重症肺炎合并肺不张患儿作为研究对象，探讨纤维支气管镜联合盐酸氨溴索治疗该疾病的疗效及安全性，为临床治疗该疾病的技术和用药提供参考。

1 材料和方法

1.1 研究……