目的 探討霧化吸入兩性霉素預(yù)防ICU住院患兒獲得性真菌性肺炎的價(jià)值。方法 采用總結(jié)性與回顧性研究方法，2015年9月-2018年1月選擇在鄭州市兒童醫(yī)院ICU住院的患兒180例作為研究對(duì)象，根據(jù)治療方法的不同分為觀察組100例與對(duì)照組80例，對(duì)照組給予常規(guī)治療，觀察組在對(duì)照組治療的基礎(chǔ)上給予霧化吸入兩性霉素治療，1次/d，直到出ICU病房。記錄兩組獲得性真菌性肺炎發(fā)生情況，記錄兩組患兒在治療期間出現(xiàn)的發(fā)熱、消化系統(tǒng)異常、電解質(zhì)失衡等并發(fā)癥情況，比較兩組外周T淋巴細(xì)胞亞群變化和炎癥因子水平。結(jié)果 觀察組與對(duì)照組的獲得性真菌性肺炎分別為0.0%和7.0%，觀察組顯著低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組治療期間的發(fā)熱、消化系統(tǒng)異常、電解質(zhì)失衡等并發(fā)癥發(fā)生率分別為9.0%和8.8%，兩組對(duì)比無顯著差異。觀察組治療后的CD4⁺值顯著增加，CD8⁺值顯著降低，與治療前對(duì)比差異顯著（P<0.05）；對(duì)照組治療前后對(duì)比無顯著差異。兩組治療后的血清腫瘤壞死因子-α（TNF-α）與白介素-6（IL-6）值顯著低于治療前（P<0.05）；且治療后觀察組上述值也顯著低于對(duì)照組（P<0.05）。結(jié)論 霧化吸入兩性霉素能有效預(yù)防ICU住院患兒獲得性真菌性肺炎的發(fā)生，且不會(huì)增加不良反應(yīng)的發(fā)生，其作用機(jī)制可能與增強(qiáng)機(jī)體免疫功能與抑制炎癥因子的釋放有關(guān)。

Objective To explore the values of inhalation of amphotericin in the prevention of acquired fungal pneumonia in ICU hospitalized children.Methods Used the summary and review research method,from September 2015 to January 2018,180 cases of ICU hospitalized children in the Children's Hospital of Zhengzhou University were selected and were divided into the observation group of 100 cases and 80 cases in the control group accorded to the different treatment methods,the control group were given routine treatment,the observation group were given inhalation of amphotericin therapy based on the control group treatment,the acquired fungal pneumonia incidence and prognosis in the two groups were recorded.Results The acquired fungal pneumonia in the observation group and the control group were 0% and 7% respectively,and the observation group were significantly lower than the control group (P<0.05).The incidence of complications such as fever,digestive system abnormality and electrolyte imbalance during the treatment of the two groups were 9% and 8.8% respectively,and there were no significant difference compared between the two groups.The CD4⁺ value of the observation group were significantly increased after treatment,and the CD8⁺ value were significantly decreased (P<0.05).There were no significant difference between the control group before and after treatment (P<0.05).The value of serum TNF-α and IL-6 in the observation group and the control group were significantly lower than that before the treatment (P<0.05),and the above values in the observation group were also significantly lower than those in the control group (P<0.05).Conclusion The atomization inhalation amphotericin can effectively prevent the occurrence of acquired fungal pneumonia in ICU hospitalized children,and it will not increase the incidence of adverse reactions.Its mechanism may be related to enhance the immune function of the body and inhibite the release of inflammatory factors.