目的 探讨雾化吸入两性霉素预防ICU住院患儿获得性真菌性肺炎的价值。方法 采用总结性与回顾性研究方法，2015年9月-2018年1月选择在郑州市儿童医院ICU住院的患儿180例作为研究对象，根据治疗方法的不同分为观察组100例与对照组80例，对照组给予常规治疗，观察组在对照组治疗的基础上给予雾化吸入两性霉素治疗，1次/d，直到出ICU病房。记录两组获得性真菌性肺炎发生情况，记录两组患儿在治疗期间出现的发热、消化系统异常、电解质失衡等并发症情况，比较两组外周T淋巴细胞亚群变化和炎症因子水平。结果 观察组与对照组的获得性真菌性肺炎分别为0.0%和7.0%，观察组显著低于对照组，差异有统计学意义（P<0.05）。两组治疗期间的发热、消化系统异常、电解质失衡等并发症发生率分别为9.0%和8.8%，两组对比无显著差异。观察组治疗后的CD4⁺值显著增加，CD8⁺值显著降低，与治疗前对比差异显著（P<0.05）；对照组治疗前后对比无显著差异。两组治疗后的血清肿瘤坏死因子-α（TNF-α）与白介素-6（IL-6）值显著低于治疗前（P<0.05）；且治疗后观察组上述值也显著低于对照组（P<0.05）。结论 雾化吸入两性霉素能有效预防ICU住院患儿获得性真菌性肺炎的发生，且不会增加不良反应的发生，其作用机制可能与增强机体免疫功能与抑制炎症因子的释放有关。

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.