雾化吸入糖皮质激素联合特布他林及异丙托溴铵治疗毛细支气管炎的疗效及预后

目的观察糖皮质激素联合异丙托溴铵、特布他林雾化吸入治疗毛细支气管炎的疗效,探讨不同疗程吸入糖皮质激素对毛细支气管炎预后的影响。方法将108例收治住院的毛细支气管炎患儿随机分为3组,均采用综合治疗。治疗1组予布地奈德混悬液联合特布他林、异丙托溴铵三联雾化吸入治疗7d,继续丙酸氟替卡松雾化吸入治疗至12周;治疗2组予布地奈德混悬液联合特布他林溶液二联雾化吸入治疗7d;对照组单用特布他林溶液雾化吸入治疗7d。观察3组患儿临床症状消失时间、住院天数,并进行临床疗效评定及追踪停药1a为喘息性疾病患病人数及患病率。结果治疗1组和治疗2组在咳嗽、喘憋症状缓解、肺部哮鸣音消失时间及缩短住院天数方面均优于对照组(Pa<0.05),治疗1组在临床缓解率方面较治疗2组更具优势(P<0.05)。治疗1组在停药1a喘息性疾病患病率明显降低,与对照组比较差异有统计学意义(P<0.05),治疗2组在停药1a喘息性疾病患病率与对照组比较稍低,但无显著性差异(P>0.05)。结论糖皮质激素联合特布他林二联雾化吸入治疗毛细支气管炎疗效肯定,糖皮质激素联合特布他林、异丙托溴铵三联雾化吸入治疗毛细支气管炎,对急性期症状的缓解优势更为明显,毛细支气管炎患儿吸入性糖皮质激素早期干预治疗至12周,可降低发展为支气管哮喘的几率。

Therapeutic Effect and Prognostic Evaluation of Atomize Inhaling Glucocorticoid,Terbutaline and Beclomethasone Ipratropine on Bronchiolitis

Objective To observe the therapeutic effect of atomize inhaling glucocorticoid,terbutaline and beclomethasone ipratropine for pedo-bron-chiolitis and explore the prognostic influence of glucocorticoid.Methods One hundred and eight patients with pedo-bronchiolitis were divided into 3 groups randomly.The patients in group 1 were treated 12 weeks with pulmicort,ipratropine and terbutaline;the patients in group 2 were treated 7 days with pulmicort and terbutaline;and the control group were treated 7 days with terbutaline only.The disappearance of the clinical symptoms and the during hospital stay were observed and clinical therapeutic effects in 3 groups were evaluated.And the number and attack rate of gasping illness was followed up 1 year after discontinuation of the treatment.Results The duration of the symptoms including cough wheezing rale and the hospital day in treatment group were superior to those in the control group (Pa<0.05).The treatment group in clinical remission rate was better,and withdraw treatment to 1 year in asthmatic disease,the prevalence rate in treatment group 1 decreased significantly(P<0.05),the prevalence rate in treatment group 2 was slightly lower than that in the control group(P>0.05).Conclusions The therapeutic effect of atomize inhaling glucocorticoid,terbutaline a for pedo-bronchiolitis is sure,using atomize inhaling glucocorticoid,terbutaline and beclomethasone ipratropine to reduce the acute symptoms of children with bronchiolitis is with the more obvious advantages.It can reduce the risk to develop asthma with inhaled glucocorticoids for 12 weeks as an early intervention.