【摘要】 目的 探讨小剂量肝素钠联合机械辅助排痰治疗小儿支气管肺炎的效果。方法回顾性分析2018年4月至2022年11月于萍乡市人民医院儿内科接受治疗的100例支气管肺炎患儿的临床资料，根据治疗方式不同分为常规组（34例）、肝素钠组（33例）、联合组（33例）。常规组采用补液、抗感染、止咳等对症治疗，肝素钠组联合小剂量肝素钠治疗，联合组在上述基础上联合机械排痰治疗，比较三组患儿的临床症状消失时间、住院时间和临床疗效。结果联合组的咳嗽消失时间、肺啰音消失时间、住院时间及退热时间均短于常规组及肝素钠组，肝素钠组的咳嗽消失时间、肺啰音消失时间、住院时间及退热时间均短于常规组，差异有统计学意义（P<0.05）。治疗7 d后，联合组的有效率高于常规组，差异有统计学意义（P<0.017）。治疗后，三组患儿的动脉血氧分压（PaO₂）、氧合指数（OI）、动脉血氧饱和度（SpO₂）水平均高于本组治疗前，动脉血二氧化碳分压（PaCO₂）水平均低于本组治疗前，且联合组的PaO₂、OI、SpO₂水平均高于肝素钠组及常规组，PaCO₂水平低于肝素钠组及常规组，肝素钠组的PaO₂、OI、SpO₂水平均高于常规组，PaCO₂水平低于常规组，差异有统计学意义（P<0.05）。治疗后，三组患儿的白细胞计数、中性粒细胞百分比水平均低于本组治疗前，且联合组的白细胞计数、中性粒细胞百分比水平均低于肝素钠组和常规组，肝素钠组的白细胞计数、中心粒细胞水平低于常规组，差异有统计学意义（P<0.05）。结论小剂量肝素钠联合机械辅助排痰治疗小儿支气管肺炎效果确切，能有效改善临床症状，缩短治疗时间。更多还原

【Abstract】 Objective To investigate the effect of low-dose heparin sodium combined with mechanical assisted expectoration in the treatment of bronchopneumonia in children.Methods The clinical data of 100 children with bronchopneumonia who were treated in the Department of Pediatrics,Pingxiang People’s Hospital,from April 2018 to November 2022 were retrospectively analyzed.According to the different treatment methods,they were divided into the conventional group （34cases）,heparin sodium group （33 cases）,and combination group （33 cases）.The conventional group was treated with symptomatic treatment such as fluid replacement,anti-infection,and relieving cough.The heparin sodium group was treated with low-dose heparin sodium,and the combination group was treated with mechanical expectoration on the basis of the above.The disappearance time of clinical symptoms,hospital stay and clinical efficacy of the three groups were compared.Results The cough disappearance time,lung rales disappearance time,hospitalization time and antipyretic time in the combination group were shorter than those in the conventional group and the heparin sodium group,and the cough disappearance time,lung rales disappearance time,hospitalization time and antipyretic time in the heparin sodium group were shorter than those in the conventional group,and the differences were statistically significant （P<0.05）.After 7 days of treatment,the effective rate of the combination group was higher than that of the conventional group,and the difference was statistically significant （P<0.017）.After treatment,the levels of partial pressure of oxygen in arterial blood （PaO₂）,oxygenation index （OI） and arterial oxygen saturation （SpO₂） in the three groups were higher than those before treatment,and the level of partial pressure of carbon dioxide in arterial blood （PaCO₂） in the three groups were lower than those beforetreatment,and the levels of PaO₂,OI and SpO₂in the combination group were higher than those in the heparin sodium group and the conventional group,and the level of PaCO₂in the heparin sodium group was lower than that in the heparin sodium group and the conventional group,the levels of PaO₂,OI and SpO₂in the heparin sodium group were higher than those in the conventional group,and the level of PaCO₂in the heparin sodium group was lower than that in the conventional group,and the differences were statistically significant（P<0.05）.After treatment,the white blood cell count and neutrophil percentage levels of the three groups were lower than those before treatment,the white blood cell count and neutrophil percentage level of the combination group were lower than those of the heparin sodium group and the conventional group,and the white blood cell count and neutrophil level of the heparin sodium group were lower than those of the conventional group,and the differences were statistically significant （P<0.05）.Conclusion Low-dose heparin sodium combined with mechanical-assisted expectoration is effective in treating children with bronchopneumonia,which can effectively improve clinical symptoms and shorten treatment time.更多还原