高渗盐水联合肾上腺素雾化吸入治疗重症毛细支气管炎的疗效观察
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摘要
目的观察高渗盐水联合肾上腺素雾化吸入治疗重症毛细支气管炎的临床疗效。方法将毛细支气管炎患儿100例依据入院顺序交替分为观察组和对照组各50例。2组均给予抗感染及对症支持治疗。观察组采用肾上腺素、3%高渗盐水联合雾化吸入治疗。对照组采用硫酸特布他林、0.9%生理盐水联合雾化吸入治疗。比较2组临床症状及体征消失时间、住院时间、临床疗效、气道炎性细胞数量变化情况及不良反应发生情况。结果观察组咳嗽、喘憋、肺部哮鸣音消失时间和住院时间均明显短于对照组(P<0.05);临床疗效优于对照组,总有效率明显高于对照组(P<0.05);气道分泌物的炎性细胞总数、淋巴细胞数、中性粒细胞数雾化吸入前后差值明显高于对照组(P<0.05)。2组不良反应发生率差异无统计学意义(P>0.05)。结论高渗盐水联合肾上腺素治疗重症毛细支气管炎能有效减少气道炎性细胞数,减轻气道高反应性,起效迅速,持续时间较长,疗效好,不良反应少,是治疗患儿毛细支气管炎安全、有效、经济、易于接受的疗法。
Objective To explore the clinical efficacy of hypertonic saline combined with adrenaline inhalation for the treatment of severe capillary bronchitis. Methods A total of 100 cases of children with severe capillary bronchitis were divided into observation group(n=50)and control group(n=50), according to the order of admission. Two groups of children were both given anti-infection,symptomatic and supportive treatment. The observation group were given epinephrine dissolved in 3% hypertonic saline for inhalation, while the control group were given terbutaline hemisulfate dissolved in 0.9% normal saline for inhalation. The clinical symptoms and signs, duration of hospitalization, clinical efficacy, changes in the number of inflammatory cells and adverse reactions were observed and compared between the two groups. Results The disappearance time of asthma suppress, cough, lung wheeze and hospital stay of the observation group were significantly shorter than those of the control group(P<0.05). The total effective was higher than the control group(P<0.05). The total number of inflammatory cells, lymphocytes and neutrophils in airway secretions were significantly higher than those in the control group before and after atomization inhalation(P<0.05). No serious adverse reactions was happened in both groups(P>0.05). Conclusion Hypertonic saline combined with epinephrine in the treatment of severe bronchiolitis can effectively reduce the number of inflammatory cells in the airway and reduce the airway hyperresponsiveness with good effect, less adverse reactions. It is a safe, effective, economical and acceptable adjuvant therapy for the treatment of bronchiolitis in children.
Objective To explore the clinical efficacy of hypertonic saline combined with adrenaline inhalation for the treatment of severe capillary bronchitis. Methods A total of 100 cases of children with severe capillary bronchitis were divided into observation group(n=50)and control group(n=50), according to the order of admission. Two groups of children were both given anti-infection,symptomatic and supportive treatment. The observation group were given epinephrine dissolved in 3% hypertonic saline for inhalation, while the control group were given terbutaline hemisulfate dissolved in 0.9% normal saline for inhalation. The clinical symptoms and signs, duration of hospitalization, clinical efficacy, changes in the number of inflammatory cells and adverse reactions were observed and compared between the two groups. Results The disappearance time of asthma suppress, cough, lung wheeze and hospital stay of the observation group were significantly shorter than those of the control group(P<0.05). The total effective was higher than the control group(P<0.05). The total number of inflammatory cells, lymphocytes and neutrophils in airway secretions were significantly higher than those in the control group before and after atomization inhalation(P<0.05). No serious adverse reactions was happened in both groups(P>0.05). Conclusion Hypertonic saline combined with epinephrine in the treatment of severe bronchiolitis can effectively reduce the number of inflammatory cells in the airway and reduce the airway hyperresponsiveness with good effect, less adverse reactions. It is a safe, effective, economical and acceptable adjuvant therapy for the treatment of bronchiolitis in children.
引文
[1] 应琴,邱悦波.孟鲁司特钠对小儿毛细支气管炎TH17/Treg的调节作用及疗效研究[J].儿科药学杂志,2016,22(5):20-22.
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[11] Khanal A,Sharma A,Basnet S,et al. Nebulised hypertonic saline (3%)among children with mild to moderately severe bronchiolitis-a double blind randomized controlled trial[J]. BMC Pediatr,2015,15:115.
[12] 刘爱红.注射用重组人干扰素α-1b雾化佐治毛细支气管炎患儿疗效观察[J].山西职工医学院学报,2016,26(5):37-38.
[13] 王浩.吸入高渗盐水及肾上腺素对毛细支气管炎患儿发作期治疗的研究进展[J].国际儿科学杂志,2014,41(3):236-239.
[14] 刘青,李虎,万俊,等.高渗盐水雾化吸入治疗毛细支气管炎的疗效观察[J].临床肺科杂志,2017,22(4):705-707.
[15] 王陈裕,华刚,楼寿增,等.3%高渗盐水联合复方异丙托溴铵治疗幼儿毛细支气管炎的临床研究[J].中国临床药理学杂志,2014,30(2):122-124.
[16] 王浩,尚云晓.吸入高渗盐水及肾上腺素对治疗急性中重度毛细支气管炎患儿疗效的研究[J].中国小儿急救医学,2015,22(1):22-26.
[17] Bao W,Liu P,Qiu Z,et al. Efficacy of add-on montelukast in nonasthmatic eosinophilic bronchitis: the additive effect on airway inflammation,cough and life quality[J]. Chin Med J(Engl),2015,128(1):39-45.
[18] 陈洋.小剂量肝素联合肾上腺素雾化吸入佐治小儿重症毛细支气管炎的临床效果研究[J].中国妇幼保健,2014,29(4):619-621.
[2] 季立洪.高渗盐水雾化吸入辅助治疗毛细支气管炎的疗效[J].宁夏医科大学学报,2017,39(7):829-831.
[3] 洪建国.进一步规范儿童雾化吸入治疗[J].中国实用儿科杂志,2016,31(12):881-883.
[4] 胡亚美.诸福棠实用儿科学[M].8版.北京:人民卫生出版社,2005:72-120.
[5] 中华儿科杂志编辑委员会,中华医学会儿科学分会呼吸学组.毛细支气管炎诊断、治疗与预防专家共识(2014年版)[J].中华儿科杂志,2015,53(3):168-171.
[6] 史军然,薛红霞,白瑞珍,等.硫酸镁联合干扰素α-1b雾化吸入治疗重症毛细支气管炎的效果分析[J].河北医科大学学报,2016,37(1):89-91.
[7] 刘文涛.布地奈德联合沙丁胺醇雾化吸入治疗小儿毛细支气管炎的临床疗效观察[J].中国医药指南,2016,14(32):171-172.
[8] 邱锐琴,乔木,苏颖.孟鲁司特钠对毛细支气管炎患儿血嗜酸性粒细胞趋化因子和干扰素γ的影响及其意义[J].河北医科大学学报,2014,35(2):156-159.
[9] Mimura T,Walker N,Aoki Y,et al. Local origin of mesenchymal cells in a murine orthotopic lung transplantation model of bronchiolitis obliterans[J].Am J Pathol,2015,185(6):1564-1574.
[10] Gracon AS,Wilkes DS. Lung transplantation:chronic allograft dysfunction and establishing immune tolerance[J]. Hum Immunol,2014,75(8):887-894.
[11] Khanal A,Sharma A,Basnet S,et al. Nebulised hypertonic saline (3%)among children with mild to moderately severe bronchiolitis-a double blind randomized controlled trial[J]. BMC Pediatr,2015,15:115.
[12] 刘爱红.注射用重组人干扰素α-1b雾化佐治毛细支气管炎患儿疗效观察[J].山西职工医学院学报,2016,26(5):37-38.
[13] 王浩.吸入高渗盐水及肾上腺素对毛细支气管炎患儿发作期治疗的研究进展[J].国际儿科学杂志,2014,41(3):236-239.
[14] 刘青,李虎,万俊,等.高渗盐水雾化吸入治疗毛细支气管炎的疗效观察[J].临床肺科杂志,2017,22(4):705-707.
[15] 王陈裕,华刚,楼寿增,等.3%高渗盐水联合复方异丙托溴铵治疗幼儿毛细支气管炎的临床研究[J].中国临床药理学杂志,2014,30(2):122-124.
[16] 王浩,尚云晓.吸入高渗盐水及肾上腺素对治疗急性中重度毛细支气管炎患儿疗效的研究[J].中国小儿急救医学,2015,22(1):22-26.
[17] Bao W,Liu P,Qiu Z,et al. Efficacy of add-on montelukast in nonasthmatic eosinophilic bronchitis: the additive effect on airway inflammation,cough and life quality[J]. Chin Med J(Engl),2015,128(1):39-45.
[18] 陈洋.小剂量肝素联合肾上腺素雾化吸入佐治小儿重症毛细支气管炎的临床效果研究[J].中国妇幼保健,2014,29(4):619-621.