目的 探讨注射用甲泼尼龙琥珀酸钠联合注射用拉氧头孢钠治疗儿童重症社区获得性肺炎的临床疗效。方法 选取2017年8月-2018年8月西安交通大学第一附属医院收治的重症社区获得性肺炎患儿80例作为研究对象，采用随机对照表法将所有患儿分为对照组和治疗组，每组各40例。对照组患儿静脉滴注注射用拉氧头孢钠，40 mg/（kg·d），2次/d，静脉滴注30 min以上。治疗组患者在对照组基础上静脉滴注注射用甲泼尼龙琥珀酸钠30 mg/kg，静脉滴注30 min以上。两组患儿均持续治疗7 d。观察两组患者的临床疗效，同时比较两组治疗前后的临床症状改善时间、动脉血气指标和血清炎性因子水平。结果 治疗后，治疗组的总有效率为92.50%，显著高于对照组的82.50%，两组比较差异具有统计学意义（P<0.05）。治疗后，治疗组患儿发热缓解时间、憋喘缓解时间、肺部啰音消失时间、咳嗽消失时间均显著短于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组动脉血氧饱和度（SaO₂）均显著升高，二氧化碳分压（pCO₂）显著下降，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后，治疗组动脉血气指标明显优于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患儿超敏C反应蛋白（hs-CRP）、肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）水平均显著降低，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后，治疗组血清炎性因子水平显著低于对照组，两组比较差异具有统计学意义（P<0.05）。结论 注射用甲泼尼龙琥珀酸钠联合注射用拉氧头孢钠治疗儿童重症社区获得性肺炎具有较好的临床疗效，能够显著改善患儿临床症状和动脉血气指标，降低血清炎性因子水平，具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Methylprednisolone Sodium Succinate for injection combined with Latamoxef Sodium for injection in treatment of severe community-acquired pneumonia in children. Methods Children (80 cases) with severe community-acquired pneumonia in the First Affiliated Hospital of Xi'an Jiaotong University from August 2017 to August 2018 were divided into control and treatment groups by random comparison table, and each group had 40 cases. Children in the control group were iv administered with Latamoxef Sodium for injection 40 mg/(kg·d), twice daily, and intravenous drip for more than 30 min. Children in the treatment group were iv administered with Methylprednisolone Sodium Succinate for injection 30 mg/kg on the basis of the control group, and intravenous drip for more than 30 min. Children in two groups were treated for 7 d. After treatment, the clinical efficacy was evaluated, and the clinical symptom remission time, arterial blood gas indexes, and serum inflammatory factors levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the treatment group was 92.50%, which was significantly higher than 82.50% in the control group, and there were differences between two groups (P < 0.05). After treatment, the time of fever relief, asthma relief, lung rale disappearance and cough disappearance in the treatment group were significantly shorter than those in the control group, and there were differences between two groups (P < 0.05). After treatment, SaO₂ in two groups were significantly increased, but pCO₂ were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the arterial blood gas indexes in the treatment group were significantly better than those in the control group, and there were differences between two groups (P < 0.05). After treatment, the levels of hs-CRP, TNF-α, and IL-6 in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the levels of serum 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 Methylprednisolone Sodium Succinate for injection combined with Latamoxef Sodium for injection has a good clinical effect in treatment of severe community-acquired pneumonia in children, can significantly improve the clinical symptoms and arterial blood gas indexes of children, reduce the levels of serum inflammatory factors, which has a certain clinical application value.