| 摘要: |
| 目的：分析常规剂量注射用甲泼尼龙琥珀酸钠联合吸入型糖皮质激素（ICS）治疗儿童难治性肺炎支原体肺炎（RMPP）的疗效，以期为临床合理用药提供参考。方法：采用回顾性研究方法，选取2017年-2018年入住我院呼吸内科确诊为RMPP并接受治疗的2~14岁患儿67例，患儿治疗期间根据病情常规给予退热、吸氧、抗感染、止咳祛痰及糖皮质激素等治疗，将糖皮质激素治疗选用常规剂量注射用甲泼尼龙琥珀酸钠的患儿纳入单药治疗组（32例），将糖皮质激素治疗选用常规剂量注射用甲泼尼龙琥珀酸钠联合雾化吸入ICS治疗的患儿纳入联合治疗组（35例），比较两组患儿治疗后发热、咳嗽、肺部啰音消失时间，影像学出现肺实变、肺不张或局限性肺气肿的患儿行纤维支气管镜术的情况，治疗2周后肺部影像学表现改变及临床疗效，治疗过程中出现药物不良反应及因病情需要增加注射用甲泼尼龙琥珀酸钠剂量或疗程病例等情况。结果：两组退热时间比较差异无统计学意义（P>0.05），联合治疗组咳嗽消失时间、肺部啰音消失时间较短（P<0.05）。联合治疗组肺实变、肺不张或局限性肺气肿的患儿病情恢复较单药治疗组好，行二次纤维支气管镜术患儿少于单药治疗组（P<0.05）。治疗2周后，联合治疗组胸片肺部阴影吸收率、治疗总有效率均高于单药治疗组（P均<0.05）。两组患儿药物不良反应比较差异无统计学意义（P>0.05），联合治疗组增加注射用甲泼尼龙琥珀酸钠疗程的比例较小（P<0.05）。结论：应用常规剂量注射用甲泼尼龙琥珀酸钠静脉给药联合ICS雾化吸入治疗儿童RMPP疗效确切，用药安全可控，值得临床治疗参考。 |
| 关键词: 儿童 难治性肺炎支原体肺炎 吸入型糖皮质激素 甲泼尼龙琥珀酸钠 |
| DOI：doi:10.13407/j.cnki.jpp.1672.108X.2020.12.008 |
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| 基金项目: |
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| Conventional Dose of Methylprednisolone Sodium Succinate Injection Combined with Inhaled Corticosteroids in the Treatment of Children with Refractory Mycoplasma Pneumoniae Pneumonia |
| Hu Gaosheng, Wang Xialin, Cai Xinxin |
| ((Xiamen Children’s Hospital, Xiamen Fujian 361006, China)) |
| Abstract: |
| Objective: To analyze the efficacy of conventional dose of methylprednisolone sodium succinate injection combined with inhaled corticosteroids (ICS) in the treatment of children with refractory Mycoplasma pneumoniae pneumonia (RMPP), so as to provide reference for rational drug use in clinic. Methods: Retrospective study method was used, 67 children from 2 to 14 years who were diagnosed as RMPP and treated in the respiratory department of our hospital from 2017 to 2018 were recruited. All children were routinely treated with antipyretic, oxygen absorption, anti-infection, cough relieving, expectoration and glucocorticoid. Children treated with glucocorticoid who were given intravenously conventional dose of methylprednisolone sodium succinate injection were extracted into the monotherapy group. Children treated with intravenous administration of conventional dose of methylprednisolone sodium succinate injection combined with ICS atomization inhalation were included into the combined treatment group. Disappearance time of fever, cough and lung rale, fiberoptic bronchoscopy performance in children with radiographic findings of pulmonary consolidation, atelectasis or localized emphysema, changes of pulmonary imaging and clinical efficacy after 2 weeks of treatment, adverse drug reactions, and cases where additional doses or course of methylprednisolone sodium succinate injection were required due to illness in two groups were compared. Results: There was no significant difference in disappearance time of fever between two groups (P>0.05). The disappearance time of cough and lung rale of the combined treatment group was significantly shorter (P<0.05). The recovery of patients with pulmonary consolidation, atelectasis or localized emphysema in the combined treatment group was better than that in the monotherapy group, and the number of cases receiving secondary fiberoptic bronchoscopy were significantly less than those in the monotherapy group (P<0.05). After 2 weeks of treatment, the absorption rate of chest radiograph lung shadow and the total effective rate in the combined treatment group was better than that of monntherapy group (P<0.05). There was no significant difference in the incidence of adverse drug reactions between two groups (P>0.05). There were fewer cases of prolonging the treatment course of methylprednisolone sodium succinate injection in the combined treatment group (P<0.05). Conclusion: Intravenous administration of conventional dose of methylprednisolone sodium succinate injection combined with ICS atomization inhalation in the treatment of children with RMPP is effective, safe and controllable, and it is worthy of clinical reference. |
| Key words: children refractory Mycoplasma pneumoniae pneumonia inhaled corticosteroids methylprednisolone sodium succinate |
