不同雾化吸入方式对慢性支气管炎治疗效果的影响

目的探讨氧气雾化吸入法与超声雾化吸入法对老年慢性支气管炎(以下简称慢支)治疗效果的影响,为选择合适的雾化吸入方式提供依据.方法将60例慢支患者随机分为氧气雾化组(氧气组)和超声雾化组(超声组),各30例,2组雾化药物及其它治疗相同.结果氧气组症状/体征改善时间较超声组显著缩短(P<0.05,P<0.01),超声雾化吸入中的SpO2较雾化吸入前显著降低(均P<0.05),氧气雾化吸入中SpO2降低不明显,氧气雾化吸入治疗不良反应如喘憋、治疗中止发生率显著低于超声组,差异具有统计学意义(P<0.05, P<0.01).结论氧气雾化吸入治疗对慢支患者刺激小,患者耐受性好,适用于老年患者上、下呼吸道疾病的治疗.     

2种雾化吸入方法治疗婴幼儿哮喘的效果观察

目的探讨超声雾化吸入与氧气雾化吸入治疗婴幼儿哮喘患者的效果。方法选取65例婴幼儿哮喘患儿,随机分成观察组(33例)和对照组(32例),观察组实施氧气雾化吸入,对照组实施超声雾化吸入。结果雾化吸入前与雾化吸入15min后观察2组患儿血氧饱和度(SpO2)、心率、呼吸等指标,存在显著差异性(p0.01)。治疗3d后2组患儿效果比较有显著差异性(p0.05),观察组疗效优于对照组。结论氧气雾化吸入用于婴幼儿哮喘更能有效地达到平喘效果,对生命体征干扰小,患儿易于接受。     

慢性支气管炎行超声雾化吸入与氧气雾化吸入疗效对比

目的:探讨超声雾化与氧气雾化两种吸入疗法对治疗慢性支气管炎的疗效,以优选最适宜的雾化吸入方式。方法:将60例临床确诊的慢性支气管炎患者随机分为超声雾化组和氧气雾化组,分别应用超声雾化和氧气雾化吸入疗法,10d后进行疗效比较。结果:两组总有效率分别为76.7%和96.7%,其差异无显著性(P>0.05)。超声雾化组显效率为40%,而氧气雾化组显效率为76.7%,氧气雾化组明显高于超声雾化组(P<0.01)。结论:对于慢性支气管炎患者氧气雾化吸入法疗效优于超声雾化吸入法,值得临床推广应用。     

不同药液量雾化吸入对婴幼儿喘息的效果观察

[目的]探讨不同平喘药液量雾化吸入对婴幼儿喘息的效果。[方法]将160例毛细支气管炎婴幼儿采用随机数字表法分为观察组和对照组各80例,对照组将雾化药液稀释至5mL,观察组将雾化药液稀释至2mL,分别经氧气驱动雾化吸入硫酸沙丁胺醇和布地奈德混悬液,观察两组雾化吸入对婴幼儿喘息的疗效、患儿喘息症状消失时间、吸入药液完全雾完所需时间、暂停次数。[结果]观察组总有效率为92.50%,高于对照组(73.75%,P0.05);观察组患儿肺部哮鸣音、喘憋症状消失时间短于对照组(P0.05);观察组患儿吸入药液完全雾完所需时间短于对照组、暂停次数少于对照组(P0.05)。[结论]选择适当的药液量雾化可提高临床治疗效果。     

不同雾化吸入方式对治疗婴幼儿毛细支气管炎的效果比较

目的:探讨不同雾化吸入方式对治疗婴幼儿毛细支气管炎的效果比较。方法:将85例婴幼儿毛细支气管炎患儿随机分为对照组43例和观察组42例,对照组采用超声雾化吸入,药物为糜蛋白酶和生理盐水;观察组采用氧气驱动雾化吸入,药物为万托林、爱全乐和布地奈德混悬液;其他抗感染、对症等治疗相同。结果:观察组雾化吸入后30min临床症状、体征消失时间与对照组比较差异有统计学意义(P<0.01)。结论:不同雾化吸入方式对婴幼儿毛细支气管炎的治疗效果不同,对缓解喘息症状氧气驱动雾化吸入更适合于婴幼儿毛细支气管炎患儿。     

协同护理干预在儿科门诊喘息性支气管炎患儿雾化吸入治疗中的应用

[目的]探讨协同护理干预在儿科门诊喘息性支气管炎患儿雾化吸入治疗中的应用。[方法]将医院儿科门诊收治的96例喘息性支气管炎行雾化吸入治疗患儿根据随机数字表法分为观察组、对照组,每组48例,对照组雾化吸入治疗期间行常规护理,观察组雾化吸入治疗期间实施协同护理干预,比较两组患儿雾化吸入治疗依从率、治疗效果、不良反应及家属满意率。[结果]观察组患儿雾化吸入治疗依从率、治疗总有效率及家属满意率高于对照组(P0.05),而不良反应发生率低于对照组(P0.05);观察组患儿咳嗽消退时间、喘憋消退时间、喘鸣音消退时间短于对照组(P0.05)。[结论]协同护理干预能有效提高儿科门诊喘息性支气管炎患儿雾化吸入治疗依从性及治疗效果,有利于改善患儿临床症状,提高患儿家属满意率。     

肾上腺素与万托林雾化吸入治疗婴幼儿喘息疗效分析

目的:分析比较肾上腺素与万托林(即舒喘灵雾化液)治疗婴幼儿喘息的效果。方法:150例喘息患儿随机分为3组,对照组40例,予普米克令舒(即布地奈德雾化液,以下简称普米克)雾化吸入,每8h1次。治疗组A55例予普米克及肾上腺素雾化吸入,每8h1次。治疗组B55例予普米克及万托林雾化吸入,每8h1次。3组均予抗感染、吸痰、拍背、吸氧等必要的对症支持治疗。观察3组气促、喘息、吸呼比、辅助呼吸肌动用等临床指标的动态变化。结果:治疗组较对照组临床指标变化显著(P<0.05)。治疗组A与治疗组B比较临床指标变化差异无显著性(P>0.05),但治疗A组显效率及60min评分优于治疗B组。结论:肾上腺素与万托林雾化吸入治疗婴幼儿喘息安全有效。且肾上腺素起效快,早期在改善毛细支气管炎病人的症状上更具优势。     

普米克令舒和博利康尼及沐舒坦氧气驱动雾化吸入治疗喘息性支气管炎的疗效观察

目的观察普米克令舒和博利康尼及沐舒坦氧气驱动化吸入治疗喘息性支气管炎的临床疗效。方法选取我院2004年1月至2006年12月诊治的婴幼儿喘息性支气管炎85例,随机分为治疗组和对照组,治疗组给予普米克令舒和博利康尼及沐舒坦雾化液以6~8L/min氧气驱动雾化吸入,对照组给予常规雾化吸入,比较两组疗效。结果治疗组治愈率91.1%,对照组治愈率72.5%,两组治愈率差异具有统计学意义(P<0.05),两组主要症状体征消失时间(咳嗽、喘息消失、肺部喘鸣音、湿啰音消失)差异具有统计学意义(P<0.01)。结论普米克令舒和博利康尼及沐舒坦氧气驱动雾化吸入治疗喘息性支气管炎疗效好,不良反应少,经济实用,适合婴幼儿使用。     

速尿雾化吸入辅助治疗小儿毛细支气管炎的护理

目的探讨速尿超声雾化吸入辅助治疗毛细支气管炎疗效及护理。方法对80例婴幼儿按入院顺序随机分成观察组和对照组，每组各40例。2组病例常规给予抗感染、吸氧、吸痰及对症支持治疗。观察组给予速尿超声雾化吸入，对照组给予病毒唑超声雾化吸入治疗，比较2组患儿症状及体征的变化以评估疗效。结果观察组40例应用速尿雾化吸入治疗毛细支气管炎，在咳嗽、喘息及喘鸣音消失时间均较对照组缩短，总有效38例，总有效率95%。2组总有效率差异有非常显著性（p〈0.05）。结论速尿雾化吸入辅助治疗毛细支气管炎可明显提高疗效。     

万托林联用超声雾化吸入疗法控制婴幼儿喘息型肺炎的疗效观察

目的观察超声雾化吸入疗法加拍背吸痰畅通呼吸道后再予万托林氧气雾化吸入疗法控制婴幼儿喘息型肺炎的疗效。方法将189例喘息型肺炎的患儿随机分为2组，治疗组146例采用常规超声雾化吸入后，拍背15min再予吸痰等措施畅通呼吸道，休息30min后，予万托林0．3-0．5ml加生理盐水2ml氧气雾化吸入；对照组143例单纯氧气雾化吸入万托林。分别观察治疗前后2组患儿的疗效。结果治疗组总有效率（95．9％）高于对照组总有效率（94．4％），p〈0．05；治疗组的疗效明显优于对照组（P〈0．01），治疗组治愈率高于对照组，p〈0．01，肺部症状体征消失的时间短于对照组，p〈0.05。结论万托林氧气雾化联用超声雾化吸入疗法控制婴幼儿喘息型肺炎的疗效优于单纯氧气雾化吸入万托林。     

Inhalation injuries

Inhalation injuries comprise three distinct clinical entities that may be classified according to the time of onset of symptoms, etiologic agents, and the anatomic location of injury. These entities are carbon monoxide toxicity, upper airway obstruction, and smoke inhalation or chemical injury. Each has a distinct pathophysiology, clinical manifestations, treatment, and prognosis. The emergency management of inhalation injury is frequently based on the health professional's degree of suspicion despite the availability of sophisticated diagnostic tests. Early aggressive treatment, including maintaining a patent airway, administering humidified oxygen and bronchodilators, and providing pulmonary toilet, is necessary to ensure the best possible outcome. Understanding the pathophysiology, clinical manifestations, diagnosis, medical management, and nursing implications of inhalation injuries can improve patient survival.     

Chlorine Inhalation

Abstract

Background: Causes of acute chlorine exposures from community pool accidents have many reported etiologies. This case series involves 13 children exposed to high levels of chlorine at two community pools after an unusual mishap in the chlorination maintenance procedure. Case Report: During maintenance, the water feeding lines to pools are normally turned off, the chemicals replaced, the water turned back on, and the chemicals then reinjected into the line. In two separate disasters in the summer of 1996, the feeding lines were not reprimed with water before the reactants, sodium hypochlorite and muriatic acid, were injected. This caused an unusually high volume of concentrated chlorinated water to be released when refed to the pool. Results: All patients were treated with beta agonists and humidified oxygen, and five were admitted. None received bicarbonate inhalation. An extensive literature review of chlorine inhalation injuries indicates considerable variance in opinions of the pathophysiology, clinical presentation and treatment modalities, especially steroids and bicarbonate inhalation. Conclusion: In community pools, failure to reprime feeding lines with water after replacing and injecting chlorinating reactants may result in severe and large-scale chlorine exposures. Beta agonist administration and humidified oxygen remains the mainstay of treatment; steroid therapy and bicarbonate inhalation are still inadequately supported.     

Inhalation injury in the burn patient

Patients who survive to hospital admission after bums with inhalation injury face a difficult and potentially prolonged course of treatment in the burn center. Continuing survival and especially functional outcome hinges on the patient's receiving comprehensive, well-coordinated care from an interdisciplinary team of skilled health care providers. The best care plan combines close monitoring of vital organ/tissue perfusion indicators, aggressive management of pulmonary compromise, and scrupulous attention to all details of nursing care. Many patients suffer complications from their injuries or treatment, and not all survive. Those who do may face prolonged and painful therapies on the way to recovery. The expert nurse managing and caring for this unfortunate population faces tremendous clinical challenges but also has the opportunity and satisfaction of helping each patient achieve the best possible outcome.