目的 探討喜炎平注射液聯(lián)合注射用低分子量肝素鈣治療小兒重癥肺炎的臨床療效。方法 選取2016年6月-2017年9月荊門市第二人民醫(yī)院收治的重癥肺炎患兒92例為研究對象，根據(jù)隨機數(shù)字表法將所有患兒分為對照組和治療組，每組各46例。對照組霧化吸入注射用低分子量肝素鈣，30 U/kg加入到0.9%氯化鈉注射液中30 mL，10~15 min/次，1次/d。治療組在對照組基礎(chǔ)上靜脈滴注喜炎平注射液，10 mg/kg加入到5%葡萄糖注射液（或0.9%氯化鈉注射液）250 mL中，1次/d。兩組患兒在治療7 d后進行療效評價。觀察兩組的臨床療效，比較兩組的動脈血氣指標、臨床癥狀改善時間、急性生理與慢性健康評分系統(tǒng)（APACHEⅡ）評分、炎性因子。結(jié)果 治療后，對照組和治療組的總有效率分別為87.0%、97.8%，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組pH值和pO₂均有顯著升高，pCO₂顯著下降，同組治療前后比較差異具有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些動脈血氣指標改善程度明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，治療組憋喘緩解時間、發(fā)熱緩解時間、咳嗽消失時間、肺部啰音消失時間、住ICU時間、呼吸機支持時間均顯著短于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組APACHEⅡ評分均顯著降低，同組治療前后比較差異具有統(tǒng)計學(xué)意義（P<0.05）；且治療組APACHEⅡ評分明顯低于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組腫瘤壞死因子（TNF-α）、超敏C反應(yīng)蛋白（hs-CRP）水平均顯著下降，同組治療前后比較差異具有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些炎性因子指標水平明顯低于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 喜炎平注射液聯(lián)合注射用低分子量肝素鈣治療小兒重癥肺炎具有較好的臨床療效，可顯著改善臨床癥狀和動脈血氣指標，降低炎性因子水平，促進患兒的恢復(fù)，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical effect of Xiyanping Injection combined with Low Molecular Weight Heparin Calcium for injection in treatment of severe pneumonia in children. Methods Children (92 cases) with severe pneumonia in Jingmen No. 2 People's Hospital from June 2016 to September 2017 were randomly divided into control and treatment groups, and each group had 46 cases. Patients in the control group were atomization inhalation administered with Low Molecular Weight Heparin Calcium for injection, 30 U/kg added into normal saline 30 mL, 10-15 min/time, once daily. Patients in the treatment group were in administered with Xiyanping Injection on the basis of the control group, 10 mg/kg added into 5% glucose solution or normal saline 250 mL, once daily. Patients in two groups were treated for 7 d. After treatment, the clinical efficacies were evaluated, and arterial blood gas indexes, clinical symptom improvement time, APACHEⅡscores, and inflammatory factors in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 87.0% and 97.8%, respectively, and there was difference between two groups (P < 0.05). After treatment, pH and pO₂ in two groups were significantly increased, but the pCO₂ in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the arterial blood gas indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, dyspnea remission time, fever relieving time, coughing disappearance time, lung rale disappearance time, ICU time, and ventilator support time in the treatment group were significantly shorter than those in the control group, and there was difference between two groups (P < 0.05). After treatment, the APACHEⅡscores in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the APACHEⅡscore in the treatment group were significantly lower than that in the control group, with significant difference between two groups (P < 0.05). After treatment, the levels of TNF-α and hs-CRP in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the inflammatory factors in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Xiyanping Injection combined with Low Molecular Weight Heparin Calcium for injection has clinical curative effect in treatment of severe pneumonia in children, can significantly improve the clinical symptoms and arterial blood gas indexes, reduce the level of inflammatory factors, and promote the recovery of children, which has a certain clinical application value.