超声雾化吸入与氧气驱动雾化吸入治疗儿童咳嗽变异性哮喘的临床疗效对比

目的对比超声雾化吸入与氧气驱动雾化吸入治疗儿童咳嗽变异性哮喘(CVA)的临床疗效。方法选择2009年2月—2012年2月在永丰县人民医院儿科住院且需要雾化吸入治疗的CVA患儿96例,按患儿入院日期单双号分为氧气组和超声组,各48例。在综合治疗基础上,氧气组患儿采用氧气驱动雾化吸入布地奈德混悬液,超声组采用超声雾化吸入布地奈德混悬液,均以7 d为1个疗程。1个疗程后观察两种患儿临床疗效,记录两组患儿咳嗽、气喘、肺部啰音等主要临床症状消失时间和不良反应发生情况。结果氧气组总有效率为95.8%,高于超声组的87.5%(P0.05);氧气组咳嗽、气喘及肺部啰音消失时间均短于超声组(P0.05)。氧气组患儿不良反应发生率为33.3%,低于超声组的81.2%(P0.05)。结论氧气驱动雾化吸入治疗儿童CVA的临床疗效优于超声雾化吸入,能快速改善患儿临床症状,且安全性良好。     

鱼金注射液和鲜竹沥超声雾化吸入佐治支气管肺炎32例

20 0 0年 1～ 12月 ,我科应用鱼金注射液和鲜竹沥超声雾化吸入佐治婴幼儿支气管肺炎 32例 ,疗效满意。现报告如下。1.一般资料6 4例均为住院支气管肺炎患儿 ,随机分为治疗组及对照组 ,各 32例。两组性别无明显差异 ,年龄 2～ 3岁 ,患儿就诊时均有咳嗽、气促、喉鸣及肺部湿罗音、痰鸣音等 ,胸部 X线提示两肺纹理增粗 ,有斑片状阴影。2 .方法两组均给输液 ,抗生素及止喘等。治疗组加用鱼金注射液(山西产 )和鲜竹沥 (杭州产 )于超声雾化器内进行雾化吸入。年龄 2～ 6月用鱼金注射液 2 ml/次 ,鲜竹沥 10 ml/次 ,生理盐水10 ml,年龄 7月～ 3岁用…     

雾化吸入治疗小儿支气管哮喘急性发作的临床疗效及C-反应蛋白水平观察

目的 观察氧气驱动雾化吸入治疗小儿支气管哮喘急性发作的临床疗效及C-反应蛋白(CRP)水平变化.方法 在常规综合治疗的基础上采用氧气驱动雾化吸入治疗小儿支气管哮喘急性发作者95例,观察患儿雾化吸入4天后治疗效果、总有效率及治疗过程中患儿不良反应,治疗前、后血氧饱和度(SaO2)、外周血白细胞计数(WBC)及血清高敏CRP(hs-CRP)水平变化.结果 氧气驱动雾化吸入治疗4天后,总有效率为97.9%,其疗效显著;雾化吸入后SaO2[(98.4±5.7)%]显著高于雾化吸入前[(81.9±5.1)%];治疗前外周血WBC及血清hs-CRP水平显著高于对照组(P＜0.01);治疗后外周血WBC及血清hs-CRP水平均显著低于治疗前(P＜0.01),外周血WBC水平与对照组相比差异无显著性(P＞0.05),但血清hs-CRP水平仍显著高于对照组(P＜0.01).结论 在常规综合治疗基础上加用氧气驱动雾化吸入治疗,是治疗小儿支气管哮喘急性发作的有效方法,血清hs-CRP定量测定可作为病情观察及指导治疗的一项客观指标.     

布地奈德雾化吸入治疗小儿支原体肺炎临床疗效观察

目的 探讨布地奈德溶液雾化吸入治疗小儿支原体肺炎的临床疗效.方法 对我院收住的100例小儿支原体肺炎随机分为治疗组与对照组,每组50例.两组患儿均给予阿奇霉素抗感染为主的综合治疗,治疗组给予布地奈德雾化吸入.比较两组患儿临床症状体征改善情况,肺部X线显示炎症吸收好转时间及住院时间.结果 与对照组相比,治疗组患儿发热、咳嗽、喘息、肺部干湿啰音或哮鸣音消失时间明显缩短,肺部X线显示炎症吸收好转时间及住院时间减少,差异有统计学意义(P＜0.05),治疗组总有效率为96%,对照组总有效率为82%,差异有统计学意义(P＜0.05).结论 布地奈德雾化吸入治疗小儿支原体肺炎,能有效地缓解支原体感染引起的顽固性咳嗽和喘息等临床症状体征,效果肯定.     

氧气驱动雾化吸入治疗小儿支气管哮喘急性发作的临床疗效观察

目的 探讨氧气驱动雾化吸入治疗小儿支气管哮喘急性发作的临床疗效.方法 2009年1月-2011年7月我院收治的小儿支气管哮喘急性发作71例,在常规综合治疗的基础上采用氧气驱动雾化吸入,治疗4d后观察临床疗效及氧气驱动雾化吸入后血氧饱和度(SaO2)变化.结果 氧气驱动雾化吸入治疗4d后,显效36例(50.70%),好转32例(45.07%),无效2例(4.23%),总有效68例,总有效率为95.77%,其疗效显著.SaO2在雾化吸入前为(88.6±4.7)%,雾化吸入后为(98.2±5.5)%,雾化吸入后SaO2显著提高(P＜0.05).氧气驱动雾化吸入过程中未见明显的不良反应发生.结论 在常规综合治疗基础上加用氧气驱动雾化吸入治疗,是治疗小儿哮喘急性发作的有效方法,并可提高患者SaO2,且不良反应少.     

普米克令舒、博利康尼雾化吸入治疗轻中度支气管哮喘疗效观察

目的探讨联合氧气驱动雾化吸入普米克令舒、博利康尼对轻中度支气管哮喘的治疗效果。方法 63例支气管哮喘患者随机分为对照组和治疗组。两组均予吸氧、抗感染、静脉氨茶碱及对症等治疗。治疗组加用普米克令舒及博利康尼氧气雾化吸入。两组均于治疗前及治疗7天后测定肺功能及动脉血气。结果两组肺功能及PaO2较治疗前均有明显改善（P〈0.01或P〈0.05）。结论联合雾化吸入普米克令舒和博利康尼治疗轻、中度支气管哮喘安全有效,并有协同作用。     

布地奈德联合盐酸氨溴索雾化吸入治疗小儿支气管肺炎的临床疗效观察

目的探讨布地奈德联合盐酸氨溴索雾化吸入治疗小儿支气管肺炎的临床疗效。方法选取2016-01~2016-08该院收治的96例小儿支气管肺炎患者为研究对象,通过随机数字表法分为观察组和对照组各48例。入院后所有患儿均给予常规治疗,对照组在此基础上雾化吸入盐酸氨溴索,观察组雾化吸入盐酸氨溴索联合布地奈德,两组均连续治疗7 d。结果观察组治愈30例,有效14例,无效4例;对照组治愈18例,有效19例,无效11例。观察组疗效明显高于对照组(P0.01);观察组气促消失时间、肺部啰音消失时间、咳嗽消失时间、体温恢复时间以及住院时间均明显短于对照组(P0.01)。结论小儿支气管肺炎通过雾化吸入布地奈德与盐酸氨溴索能够改善患儿临床症状及体征,提高疗效。     

布地奈德混悬液联合沙丁胺醇溶液雾化吸入治疗支气管哮喘急性发作疗效观察

目的 观察布地奈德混悬液联合沙丁胺醇溶液经氧驱动雾化吸入治疗急性发作轻～中度支气管哮喘疗效.方法 将2009年3月～2011年3月我院就诊支气管哮喘患者56例分为治疗组(n=30例)和对照组(n=26例).治疗组在传统治疗基础上加用布地奈德混悬液和沙丁胺醇溶液各2ml加入生理盐水2ml中进行高流量氧气驱动雾化吸入,q12h.对照组为传统治疗方案.治疗组和对照组疗程均7天.结果 治疗组有效率90.00％,对照组有效率65.38％,两组疗效比较差异有显著性(P＜0.05).全身激素用量治疗组较对照组少,两组比较差异有显著性(P＜0.01).结论 布地奈德混悬液联合沙丁胺醇溶液雾化吸入治疗支气管哮喘起效快、疗效肯定.     

两种雾化吸入方式对COPD治疗效果的对比研究

目的观察两种不同雾化吸入方法对慢性阻塞性肺疾病（COPD）患者肺功能及血氧饱和度的影响。方法将62例COPD患者随机分为观察组和对照组,各31例,用相同剂量硫酸沙丁胺醇雾化吸入。观察组用面罩氧气雾化吸入法,对照组用超声雾化吸入法,比较两组治疗前、后第1秒钟用力呼气容积（FEV1）、最大呼气峰流速（PEF）及PaO2、PaCO2的变化。结果两组治疗前FEV1、PEF与治疗后比较、差异有显著意义（P〈0.05、P〈0.05）;观察组PaO2、PaCO2治疗前、后差异有显著意义（均P〈0.05）;治疗后观察组各观察指标较对照组显著改善（均P〈0.05）。结论面罩氧气雾化吸入法能降低COPD患者的呼吸道阻力,改善肺功能,其治疗效果优于超声雾化吸入法。     

雾化吸入不同剂量布地奈德混悬液对AECOPD患者的治疗作用及安全性评估

目的 探讨雾化吸入不同剂量的布地奈德混悬液对慢性阻塞性肺疾病急性加重期(AECOPD)患者的治疗效果及安全性评估.方法 84例AECOPD患者被随机分为大剂量组(30例)、一般剂量组(28例)、和对照组(26例).三组均给予吸氧、抗菌素、氨茶碱及止咳化痰等常规治疗.大剂量组加用布地奈德混悬液4mg氧气吸入3次/天.一般剂量组加用布地奈德混悬液2mg氧气吸入3次/天.三组均治疗前及治疗后4小时、72小时、10天测定肺功能、动脉血气.治疗前后测空腹血糖、骨代谢指标.结果 治疗前三组间各指标比较无明显差异(P>0.05).治疗后4小时大剂量组与治疗前比较有显著差异性(P<0.05)而其余两组均无显著差异性(P>0.05).治疗后72小时大剂量组和一般剂量组与治疗前比较均有显著性差异(P<0.01或P<0.05).两组间比较也有显著性差异(P<0.05),而对照组无显著性差异.10天后三组均与治疗前比较有显著性差异(P<0.01或P<0.05).而大剂量组与一般剂量组比较无显著性差异(P>0.05).与对照组比较仍有显著性差异.治疗后三组间血糖、骨代谢各指标与治疗前无显著性差异(P>0.05).结论 大剂量布地奈德混悬液雾化吸入治疗AECOPD起效快而安全.     

Future directions in aerosol therapy

An unprecedented growth in new technology and clinical applications of aerosol therapy is forecast for the new millennium. The most promising areas of investigation in the aerosol field relate to improvements in the pulmonary deposition of aerosol, improved synchronization between the patient's breathing and aerosol generation, targeting of aerosol to specific sites in the lung, improvements in the formulations of inhaled drugs, modulated release of inhaled drugs, and use of inhaled drugs for systemic therapy. Moreover, gene therapy by the inhaled route offers the prospects of a cure for a variety of pulmonary disorders. Future developments in the aerosol field are expected to radically change the management of patients across several medical specialties.     

Ribavirin aerosol treatment of influenza

In this article we have described the clinical and laboratory features of uncomplicated influenza in college students and its treatment with ribavirin aerosol. The disease presents as an acute febrile systemic illness of short duration that varies little from patient to patient. Peripheral blood cell changes in the infection are also quite specific and very consistent. Polymorphonuclear cell counts are slightly increased above normal early in infection at a time when lymphocyte counts were greatly reduced. As lymphocyte numbers increase at the third day of illness, polymorphonuclear cell counts diminish substantially. Eosinophil counts fluctuate in a pattern similar to that of lymphocytes. Basophil, monocyte, and band cell counts are increased at admission and thereafter decline in numbers. Reticulocytes and platelets are reduced during acute illness. We assume that changes in peripheral white blood cell counts during influenza result from migration of cells to the inflamed respiratory tract and subsequent resupply of the various types of cells to the circulation from other sites in the body. The cellular alterations in the circulation and at the site of infection are of fundamental importance in the pathogenesis of infection, and a better knowledge of them should open new avenues for prevention and treatment. Aerosol treatment was shown to alleviate the symptoms of influenza and to reduce the shedding of influenza virus from the respiratory tract. No evidence of untoward effect of ribavirin treatment on peripheral white or red blood cells was found, and a wide range of clinical chemical tests revealed no toxic effects of treatment. There was no pulmonary irritation detected from the treatment. Reference was made to prompt recovery of four patients with influenzal pneumonia treated with ribavirin aerosol. Ribavirin aerosol must produce its major therapeutic effect through inhibition of virus replication at the sites of infection in the respiratory epithelium. This appears to result mainly from interference with viral messenger RNA initiation and elongation. This is best demonstrated by the prompt decline in viral shedding in treated patients. The associated prompt clinical improvement suggests that illness results from continued virus replication, and when virus replication is retarded, improvement follows. Although treatment promptly reduces illness and virus shedding, antibody response is not reduced in treated patients. We emphasized that ribavirin aerosol had a major therapeutic effect on infections caused by both influenza A and B viruses, and the picture of illness with these types of influenza was not clinically distinguishable.(ABSTRACT TRUNCATED AT 250 WORDS)     

Immunization by a bacterial aerosol

By manufacturing a single-particle system in two particulate forms (i.e., micrometer size and nanometer size), we have designed a bacterial vaccine form that exhibits improved efficacy of immunization. Microstructural properties are adapted to alter dispersive and aerosol properties independently. Dried "nanomicroparticle" vaccines possess two axes of nanoscale dimensions and a third axis of micrometer dimension; the last one permits effective micrometer-like physical dispersion, and the former provides alignment of the principal nanodimension particle axes with the direction of airflow. Particles formed with this combination of nano- and micrometer-scale dimensions possess a greater ability to aerosolize than particles of standard spherical isotropic shape and of similar geometric diameter. Here, we demonstrate effective application of this biomaterial by using the live attenuated tuberculosis vaccine bacille Calmette-Guérin (BCG). Prepared as a spray-dried nanomicroparticle aerosol, BCG vaccine exhibited high-efficiency delivery and peripheral lung targeting capacity from a low-cost and technically simple delivery system. Aerosol delivery of the BCG nanomicroparticle to normal guinea pigs subsequently challenged with virulent Mycobacterium tuberculosis significantly reduced bacterial burden and lung pathology both relative to untreated animals and to control animals immunized with the standard parenteral BCG.     

雾化吸入治疗的研究进展

雾化吸入治疗的目的是将药物输送到呼吸道疾病患者的上、下呼吸道内,与其他给药方式相比,雾化给药可达到较高的局部药物浓度,减少全身不良反应。近年来雾化吸入制剂和技术发展迅速,使药物在呼吸道的浓度增高,疗效提高。该文对雾化吸入治疗的国内外研究进展进行综述。     

Immunization against measles by aerosol

About 20 years ago, Japanese and American investigators found that inhalation of relatively small amounts of aerosolized, partly attenuated measles vaccines was consistently immunogenic in nearly all susceptible children. The resulting modified measles was not transmissible to susceptible children. In 1965-1966, Japanese investigators showed that levels of neutralizing antibody produced by killed measles virus vaccine, which prevented subsequent immunization when live vaccine was given subcutaneously, did not prevent the immunogenic effect of the same vaccine given by aerosol. This raised the possibility that aerosolized vaccine may be immunogenic in infants with residual maternal antibody, in whom subcutaneously injected vaccine is ineffective. In 1971, Soviet investigators reported the high effectiveness and complete lack of febrile and other clinical reactions in 3,306 children who were exposed in large groups in large tents or chambers to aerosols of the more-attenuated measles vaccines that were currently available. An inexpensive nebulizer and the procedure for administration of aerosolized vaccine to individual children are here described. If the good results reported from the USSR can also be obtained with this simple method of vaccination by aerosol, it may be possible to carry out mass vaccinations against measles with thousands of nonprofessional personnel and thereby quickly eliminate measles in countries where it is still a serious public health problem.     

Formoterol suspension aerosol. Comparison with formoterol solution aerosol for 12 weeks in asthmatic patients.

Formoterol solution aerosol has proved to be a fast and long-acting beta 2-sympathicomimetic drug in many clinical trials. The physical stability, however, was such that storage needed to be at 4 degrees C to 8 degrees C before first use; afterwards, the aerosol could be used for another three months at room temperature. To improve the stability, new ways have been investigated to formulate ann aerosol with improved shelf life and thus more convenient storage conditions, which was reached with a formoterol suspension aerosol. Equivalent single doses between the two formulations revealed no differences in onset or duration of action. In a double-blind, randomized parallel group multicenter study, organized in the Netherlands, 186 patients with stable asthma and reversible airway obstruction were treated either with one puff of 12 micrograms twice daily of formoterol metered dose inhaler (MDI) supension (SP) or a same dose of solution (SL) aerosol for 12 weeks to study the efficacy and tolerability of both presentations after a longer period of use. The following criteria of effectiveness were used: the FEV1 values on the mornings of the control days at 0, +4, +8, and + 12 weeks, the peak flow values (PEF) in the mornings and in the evenings before, and 1/2 to 1 h after treatment, the number of asthma attacks at night and during the day, the number of extra puffs at night and during day, and the subjective impression of patients and investigator. RESULT: No statistically significant differences between the two formoterol preparations were found. There was no indication of tachyphylaxis. CONCLUSION: The results are consistent with the hypothesis that the biologic effects of formoterol when delivered from MDI containing the two different formulations of the drug are equivalent.