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Objective:To assess the left ventricular function and hemodynamic status in infantile pneumonia by ultrasonic cardiac output monitor (USCOM).Methods:The clinical data of 74 children with infantile pneumonia hospitalized in the Department of Pediatrics of Affiliated Hospital of North Sichuan Medical College from October 2018 to January 2020 were collected in this study, and those cases were divided into the mild pneumonia group (45 cases) and the severe pneumonia group (29 cases). USCOM was employed to measure such data of patients in both groups as heart rate (HR), flow time corrected (FTc), stroke volume variability (SVV), stroke volume index (SVI), cardiac index (CI), inotropy index(INO), and systemic vascular resistance index (SVRI). The specific values of CI and SVRI in all ages were employed to determine the hemodynamic type.According to values of CI, they were grouped into normal, high and low output; according to values of SVRI, they were grouped into normal, high and low resistance.The left ventricular function and hemodynamic status of infants with pneumonia in both groups were compared.Results:(1) In the mild pneumonia group, 42.22% of infants (19/45 cases) presented with abnormal hemodynamic status, of which 94.74% were high-output and low-resistance type.In the severe pneumonia group, 79.31%(23/29 cases) of infants presented with abnormal hemodynamic status, of which 86.96%(20/23 cases) were non-high-output and non-low-resistance type.The proportion of different hemodynamic types from high to low in order is as follows: low-output and high-resistance (39.13%), high-output and normal-resistance (26.09%), low-output and low-resistance (13.04%), and normal-output and low-resistance (8.70%). (2)Before treatment, HR, SVI, CI, INO and SVRI in the severe pneumonia group and the mild pneumonia group were (153.2±19.3) times/min, (32.0±5.8) mL/m 2, (4.3±1.0) L/(min·m 2), (1.1±0.4) W/m 2, (1 139.0±280.6) d·s·cm -5·m 2 and(140.2±13.2) times/min, (39.2±4.1) mL/m 2, (5.1±0.8) L/(min·m 2), (1.4±0.2) W/m 2, and (904.7±175.8) d·s·cm -5·m 2, respectively.SVI, CI and INO in the severe pneumonia group were lower than those in the mild pneumonia group, which indicated that the difference was statically significant (all P<0.05). HR and SVRI in the severe pneumonia group were higher than those in the mild pneumonia group, which indicated that the difference was statically significant (all P<0.05). There was no significant difference in cardiac preload between both groups before treatment ( P>0.05). HR in the severe pneumonia group after treatment[(137.6±9.3) times/min] were significantly lower than before treatment, while SVI and CI[(36.2±3.4) mL/m 2, (4.7±0.3)L/(min·m 2)] were higher than before treatment, which indicated that the differences were statistically significant (all P<0.05). Conclusions:The USCOM provided a rapid approach for the dynamic measurement of left ventricular function and hemodynamic status.As per the findings with USCOM, more infants with mild pneumonia presented with hemodynamic abnormalities, and most of them were high-output and low-resistance types.The majority of infants with severe pneumonia presented with different types of hemodynamic abnormalities, and most of them were non-high-output and non-low-resistance types, which can return to normal after treatment.
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Objective To discuss the effect of Yanhuning Injection combined with amoxicillin and clavulanate potassium in treatment of infantile pneumonia.Methods Totally 1 00 infants with pneumonia were selected.They were randomly divided into two groups,the observation group (52 cases) were given Yanhuning Injection combined with amoxicillin and clavulanate potassium.The control group (48 cases) were given Yanhuning Injection.The effect of Yanhuning Injection combined with amoxicillin and clavulanate potassium in treatment of infantile pneumonia was evaluated using efficacy,cough,pulmonary rales disappeared time,pyretolysis time,pulmonary function indexes and adverse reaction during treatment as indexes.Results The effective rate was 92.3％ in the observation group and 75.0％ in the control group.The effective rate in the observation group was higher than that of the control group (P ＜ 0.05).The cough,pulmonary rales disappeared time of the observation group was shorter than that of the control group (P ＜ 0.05).There was no statistical significance on pyretolysis time between two groups.Before treatment,there was no statistical significance on FVC,FEV1 and FEV1/FVC％ between two groups.After treatment,the FVC,FEV1 and FEV1/FVC％ were increased and higher in the observation group (P ＜ 0.05).During treatment,there was no statistical significance on adverse reaction between two group.Conclusion Yanhuning Injection combined with amoxicillin and clavulanate potassium has a good effective on infantile pneumonia.It could improve the symptoms of pneumonia and lung function while inhibiting inflammation with good safety.It was worthy of clinical application.
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Objective To discuss the effect of Yanhuning Injection combined with amoxicillin and clavulanate potassium in treatment of infantile pneumonia.Methods Totally 1 00 infants with pneumonia were selected.They were randomly divided into two groups,the observation group (52 cases) were given Yanhuning Injection combined with amoxicillin and clavulanate potassium.The control group (48 cases) were given Yanhuning Injection.The effect of Yanhuning Injection combined with amoxicillin and clavulanate potassium in treatment of infantile pneumonia was evaluated using efficacy,cough,pulmonary rales disappeared time,pyretolysis time,pulmonary function indexes and adverse reaction during treatment as indexes.Results The effective rate was 92.3％ in the observation group and 75.0％ in the control group.The effective rate in the observation group was higher than that of the control group (P ＜ 0.05).The cough,pulmonary rales disappeared time of the observation group was shorter than that of the control group (P ＜ 0.05).There was no statistical significance on pyretolysis time between two groups.Before treatment,there was no statistical significance on FVC,FEV1 and FEV1/FVC％ between two groups.After treatment,the FVC,FEV1 and FEV1/FVC％ were increased and higher in the observation group (P ＜ 0.05).During treatment,there was no statistical significance on adverse reaction between two group.Conclusion Yanhuning Injection combined with amoxicillin and clavulanate potassium has a good effective on infantile pneumonia.It could improve the symptoms of pneumonia and lung function while inhibiting inflammation with good safety.It was worthy of clinical application.
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Objective To research application of quality control circle activity in the treatment of infantile pneumonia by aerosol inhalation. Methods Carry out the quality control circle activity with the theme of "improving the efficiency of the oxidation atomization inhalation", using the method of PDCA cycle, statistics of inhalation of children, analyze the reasons for the failure of atomization inhalation, set up the improvement target, make the countermeasure and organize the implementation. Then clinical symptoms (the time of evacuation, the time of lung rale disappearance and the time of fever suppression ), hospitalization time, Heart failure rate, nosocomial infection rate, recurrence rate, compliance, satisfaction degree, treatment effect were compared two groups of quality control circle activities before and after. Results After implementation, children with wheeze disappearance time, pulmonary rales disappeared time, cooling time, hospitalization time were significantly lower than the before implementation, the difference was statistically significant(P<0.05); Incidence of heart failure, nosocomial infection rate, recurrence rate were significantly lower than the before implementation, the difference was statistically significant(P<0.05), compliance were significantly higher than the before implementation, the difference was statistically significant(P<0.05); Nursing satisfaction were significantly higher than the before implementation, the difference was statistically significant(P<0.05); total effective rate were significantly higher than the before implementation, the difference was statistically significant(P<0.05). Conclusion Quality control circle activity can achieve satisfactory results in the treatment of children's pneumonia by aerosol inhalation, can reduce the occurrence of adverse events, is conducive to the prognosis of children, so as to improve treatment efficacy and satisfaction.
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Objective To research application of quality control circle activity in the treatment of infantile pneumonia by aerosol inhalation. Methods Carry out the quality control circle activity with the theme of "improving the efficiency of the oxidation atomization inhalation", using the method of PDCA cycle, statistics of inhalation of children, analyze the reasons for the failure of atomization inhalation, set up the improvement target, make the countermeasure and organize the implementation. Then clinical symptoms (the time of evacuation, the time of lung rale disappearance and the time of fever suppression ), hospitalization time, Heart failure rate, nosocomial infection rate, recurrence rate, compliance, satisfaction degree, treatment effect were compared two groups of quality control circle activities before and after. Results After implementation, children with wheeze disappearance time, pulmonary rales disappeared time, cooling time, hospitalization time were significantly lower than the before implementation, the difference was statistically significant(P<0.05); Incidence of heart failure, nosocomial infection rate, recurrence rate were significantly lower than the before implementation, the difference was statistically significant(P<0.05), compliance were significantly higher than the before implementation, the difference was statistically significant(P<0.05); Nursing satisfaction were significantly higher than the before implementation, the difference was statistically significant(P<0.05); total effective rate were significantly higher than the before implementation, the difference was statistically significant(P<0.05). Conclusion Quality control circle activity can achieve satisfactory results in the treatment of children's pneumonia by aerosol inhalation, can reduce the occurrence of adverse events, is conducive to the prognosis of children, so as to improve treatment efficacy and satisfaction.
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Objective To investigate the clinical efficacy of ambroxol intravenous and budesonide atomizing inhalation combined with cefodizime on infantile pneumonia and its effects of serum PCT, IL -6 levels and related immune factors.Methods 95 children with pneumonia from May 2013 to October 2015 in Sanya Hospital of Traditional Chinese Medicine were collected and randomly divided into control group(n=47) and experiment group (n=48), two groups were treated by clinical routine treatment, such as antipyretic, anti-inflammatory, strengthen nutrition in children, and control group were added with ambroxol, iv, qd; experiment group were added cefodizime on the basis of control group, the course was one week.Clinical efficacy,serum PCT, IL -6 levels, immune factors and adverse reactions were observed and compared.Results The serum PCT and IL -6 levels of experiment group were lower than control group post-treatment, and CD4 +, CD4 +/CD8 +levels were higher than control group, CD8 +level was lower than control group, the differences were all significant (P<0.05).The effective rate of experiment group was 93.75%, higher than 80.85% of control group(P<0.05).Incidence of adverse reactions between two groups had no statistical difference.Conclusion Ambroxol intravenous and budesonide atomizing inhalation combine with cefodizime in treatment of infantile pneumonia has better clinical efficacy, could effectively reduce the serum PCT and IL-6 levels, effectively improve the clinical symptoms.
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Objective To analyse effects of zinc on immune function in children with infantile pneumonia .Methods A total of 96 children with infantile pneumonia selected from May to July 2014 were randomly divided into zinc supplementary treatment group and routine treatment group ,with 48 cases in each group .Routine treatment group was given conventional treatment ,while the zinc supplementary treatment group was received conventional treatment combined with zinc supplement .The serum level of zinc and immune function were detected before and after treatment ,respectively .Other 40 healthy infants received physical examination were contemporarily selected as healthy control group .Results Before treatment ,the levels of serum zinc ,IgA ,IgM and IgG ,percentages of CD3+ ,CD4+ cells and the CD4+ /CD8+ ratio in the two groups of children with infantile pneumonia were lower than those in the healthy control group ,while percentage of CD8+ cells was lower than that in the healthy control group ,had statistically significant differences(P 0 .05) .After treatment ,the levels of serum zinc , IgA ,IgM and IgG ,percentages of CD3+ ,CD4+ cells and the CD4+ /CD8+ ratio in the zinc supplementary treatment group were higher than those in the routine treatment group ,and percentage of CD8+ cells was lower than that in the routine treatment group , had statistically significant differences(P<0 .05);while compared with the healthy control group ,levels of serum zinc ,IgA ,IgM , IgG were still lower ,had statistically significant differences(P<0 .05) .After treatment ,levels of serum zinc ,IgA ,IgM ,IgG ,per‐centages of CD3+ ,CD4+ cells and the CD4+ /CD8+ ratio in the routine treatment group were still lower than those in the healthy control group ,and percentage of CD8+ cells was still higher than that in the healthy control group ,had statistically significant differences(P<0 .05) .Conclusion Zinc can effectively improve the immune function of children with infantile pneumonia ,which might shorten treatment time and reduce adverse outcomes .
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Objective To explore the clinical value of the serum cystatin C (Cys C) changes in different periods of the infantile pneumonia.Methods Ninety-two cases of infantile pneumonia (59 mild pneumonia patients and 33 severe pneumonia patients) from November 2012 to March 2013 were collected and 40 cases of healthy infant were enrolled for control group.The levels of serum Cys C,urea and creatinine in acute and recovery period were detected.Results In severe pneumonia patients,the average level of Cys C in acute period [(1.98±0.33) mg/L] is significantly higher than that in control group [(0.85 ±0.24) mg/L] (P ＜0.01),and there was no significant difference between recovery period [(1.12 ± 0.23) mg/L] and control group (P ＞ 0.05),and there was significant difference between acute and recovery period (P ＜0.05).In mild pneumonia patients,there were no significant differences in the level of Cys C between the acute period [(1.10 ±0.22) mg/L] and recovery period [(0.94 ±0.21) mg/L] as well as control group (P ＞ 0.05).The positive rate of Cys C in severe pneumonia patients (51.9％,14/27) was higher than that of urea and creatinine (3.7％,1/27) (P ＜0.01).Conclusion Severe pneumonia could result in renal dysfunction,which is reversible.Cys C can be the clinical reference for early diagnosis and the therapeutic effect in severe pneumonia patients with renal dysfunction.