吸入疗法治疗支气管哮喘38例

我科于 1997年 4月开始应用吸入疗法治疗小儿支气管哮喘 ,现将治疗时间在 1.5ａ以上、资料完整的 38例总结如下。临床资料一、对象　 38例支气管哮喘来自本院呼吸门诊 ,均符合1993年全国儿科哮喘防治协作组标准。男 2 3例 ,女 15例 ,年龄 2ａ 4个月～ 12ａ 8个月 ,平均年龄 6ａ 6个月。哮喘分度 :轻度 16例 ,中度 18例 ,重度 4例。 38例既往反复静脉或口服用药 ,现均改为吸入疗法。二、药物及用法　药物为北京集爱制药公司生产的沙丁胺醇、色苷酸钠及丙酸倍氯米松。急性发作期均吸入沙丁胺醇 ,每次 10 0ｍｇ ,每日 2～ 3次 ,症状控制后逐渐…     

长期吸入皮质激素对哮喘患儿骨密度的影响

目前，吸入皮质激素治疗哮喘已被推荐为一线药物，但对于激素气雾剂与小儿骨代谢之间的关系研究不多。因此我们观察了15例长期吸入皮质激素哮喘患儿的骨矿含量，并将结果同以往的正常对照组有关数据相比较。对象和方法一、对象15例哮喘息儿均来自我院儿科哮喘专科门诊，其中男11例，女4例。5～10岁9例，～15岁6例。应用必可酮气雾剂（重庆葛兰素制药有限公司）吸入时间1／2～2年，其中1／2年3例，～l年8例，～2年《例；10例最初剂量300＃g／天，5例为400u4／天。全部病例于症状控制后4～8周开始减量50～100ug／次，减至100ng／天为维持量，…     

319例哮喘患儿喘乐宁雾化吸入前后肺功能变化

３１９例哮喘患儿喘乐宁雾化吸入前后肺功能变化李元陈育智李硕赵京韩秀兰丁燕通过对哮喘患儿进行喘乐宁雾化吸入前后肺功能的监测、分析，为临床提供判断病情的客观指标，以利于指导临床的治疗工作。方法：３１９例观察对象全部来自我所哮喘专业门诊的患儿，诊断按１９９...     

皮质激素吸入疗法防治小儿哮喘的进展

皮质激素吸入疗法是目前防治小儿哮喘的最有效方法,近年来供吸入的倍氯米松,布地奈德,氟替卡松等具有疗效确切,副作用小的特点,潜在性不良反应与剂量及吸入技术有关,焦点在于有合适的指征及吸入皮质激素的治疗方法。     

普米克吸入治疗支气管哮喘46例

我科自１９９５年８月起应用普米克吸入治疗支气管哮喘病儿,并进行了临床观察。现将药物治疗２ａ以上资料完整的４６例进行总结。临床资料一、一般资料　支气管哮喘病儿４６例,男３３例,女１３例,年龄２．２５～１２．７５ａ。平均６．４２ａ。病程１５０ｄ～１１．２ａ。哮喘分级轻度１９例,中度１８例,重度９例。全部符合全国儿童哮喘防治协作组制订标准［１］。４６例既往反复静脉或口服用药（抗生素、糖皮质激素、氨茶碱等）仍然有经常反复哮喘发作。现改用吸入治疗。二、最大呼气流速（ＰＥＦ）值测定　４６例中有３７例（＞５ａ…     

哮喘的吸入治疗和吸入装置

哮喘是一种气道慢性炎症性疾病,必须坚持长期、持续、规范、个体化的治疗,因此,选择合适的药物和给药途径十分重要。 一、哮喘药物给药途径 (一)全身给药:一般药物经胃肠道给药后约有50％可吸收入机体,而仅有1％左右的药量达到肺部。经胃肠外给药虽然药物能迅速进入全身,但达到肺部的药量仍占很小比例。因此全身给药剂量较大,局部药物与全身药物浓度比值     

吸入二丙酸倍氯米松气雾剂治疗小儿哮喘对骨密度影响的研究

目的探讨长期吸入二丙酸倍氯米松治疗儿童哮喘对骨密度的影响。方法对3～15岁68例哮喘儿童给予吸入二丙酸倍氯米松，吸入剂量≤400μg／d，分级阶梯治疗，定期复查。分别于吸入前、后测骨密度(BMD)。根据吸入时间将68例患儿分3组(随患儿年龄增长，将患儿调入相应的年龄组)，A组68例，吸入时间≥6个月；B组65例，吸入时间≥1年；C组56例，吸入时间≥2年。每组又根据BMD正常参考值分3～6岁组，7～13岁组，采用SAS软件对每例哮喘儿童治疗前和治疗中测的BMD均数值分组进行配对资料t检验。结果经随访观察吸入二丙酸倍氯米松治疗≥6个月、≥1年、≥2年哮喘儿童BMD均数值与治疗前比较均无明显区别。显示吸入二丙酸倍氯米松≤400μg／d治疗哮喘，3年内是安全的。结论吸入二丙酸倍氯米松每天剂量≤400μg／d，3年内应用是安全的，对哮喘儿童骨密度无明显影响。     

应用儿科哮喘生命质量调查问卷评估儿童哮喘吸入疗法

支气管哮喘是一种严重影响人们生活质量的慢性身心疾病。目前该病对生命质量的影响在国外备受关注,但国内此方面研究尚少。我们于2001年1—12月应用儿科哮喘生命质量调查问卷(pediatric asthma quality of life questionnaire,PAQLQ)对儿童哮喘治疗效果进行评估。     

哮喘患儿瘦素水平及吸入糖皮质激素对其影响

为了探讨哮喘患儿在发作时的血清瘦素水平及长期吸入糖皮质激素(二丙酸倍氯米松)的影响,选择6～10岁的无肥胖和第二性征的儿童作为对象。考虑到男女间的瘦素差别,按男女分别将他们分为正常对照组和哮喘组,哮喘组再分成未吸入组、短期吸入组和长期吸入组。用SPSS软件统计处理。结果:正常对照组、未吸入组、短期吸入组和长期吸入组4组间激素水平无明显差异(P>0.05),男女间瘦素水平也无明显差异(P>0.05)。提示哮喘患儿吸入糖皮质激素治疗,其血清瘦素的水平无明显差异,说明吸入糖皮质激素治疗通常不会造成患儿肥胖和瘦素分泌紊乱;性前期儿童男女间瘦素水平无明显差异,提示瘦素水平与性激素和性发育有关。     

儿童支气管哮喘的远期转归及影响因素研究进展

儿童支气管哮喘患病率逐年上升,但控制率不足三分之一.病例对照研究及队列研究提示儿童期哮喘可持续至青少年甚至中老年,肺功能受损亦始于生命早期并持续存在.及时确诊并介入规范化个体化药物控制治疗、特异性免疫治疗和随访管理干预,定期监测肺功能受损情况,同时改善不良环境因素,可能有助于改善儿童哮喘的远期转归.     

Determinants of correct inhalation technique in children attending a hospital-based asthma clinic

Many children with asthma use their inhaler device incorrectly even after comprehensive inhalation instruction. The aim of this study was to identify factors associated with correct inhalation technique. Two hundred children with asthma demonstrated their inhalation technique. Patient characteristics and the components of inhalation instructions they had received were compared for children demonstrating a correct or incorrect inhalation technique. In addition, the inhalation technique of 47 newly referred patients was followed-up prospectively after repeated comprehensive instruction sessions. Seventy-eight percent of all patients demonstrated a correct inhalation technique. Patients who had received repeated instruction sessions and patients who had previously been asked to demonstrate the use of their inhaler during an instruction session were more likely than other children to demonstrate a correct inhalation technique (p < 0.001 and p = 0.03, respectively). Multiple logistic regression analysis showed that repetition of instructions was significantly associated with a correct inhalation technique (odds ratio (OR) 8.2, 95% CI 3.2-21.5; p < 0.0001) irrespective of type of inhaler used. Demonstration of the inhaler use by the patient was significantly associated with a correct inhalation technique for patients using a metered dose inhaler plus spacer device (OR 3.5, 95% CI 1.0-12.6; p = 0.05). but not for patients using a dry powder inhaler (OR 1.6, 95% CI 0.4-6.4; p = 0.54). The number of newly referred patients demonstrating a correct inhalation technique improved from 57.4% to 97.9% after three comprehensive instruction sessions. CONCLUSION: Inhalation instruction should be given repeatedly to achieve and maintain correct inhalation technique in asthmatic children.     

Assessment of asthma severity and asthma control in children

National and international guidelines for asthma recommend the assessment and documentation of severity as the basis for patient management. However, studies show that there are problems with application of the severity assessment to children in clinical practice. More recently, asthma control has been introduced as a method to assess the adequacy of current treatment and inform asthma management. In this article we review the application and limitations of the severity assessment and the asthma-control tools that have been tested for use in children. A system of using asthma severity for disease assessment in the absence of treatment and using asthma-control assessment to guide management decisions while a child is receiving treatment appears to be a promising approach to tailor treatment to improve care and outcomes for children with asthma.     

Under diagnosis of asthma in school children and its related factors

A cross-sectional study was carried out on one thousand school children studying in three public schools of Delhi and Haryana between 10 to 17 year age group over the period of one year (2001-02). It aimed in studying under diagnosis of asthma in school children and its related factors. Questionnaires including details of medical, social, environmental factors precipitating asthma were filled by the parents and class teachers. Pulmonary function test (PFT) was performed. Based on questionnaires and PFT results, children were grouped as labeled and unlabeled asthmatics. Cough was found to be equally prevalent in both the groups while wheezing and shortness of breath were independent and significant factors associated with getting a physician diagnosis.     

农村儿童事故倾性的现况及影响因素的研究

目的 研究农村儿童事故倾性发生的现况,并探讨其影响因素,为农村儿童事故倾性的预防及干预提供科学依据.方法 按随机整群抽样的方法,采用自制的一般情况调查表和伤害调查表对湖南省某农村1 560名儿童进行问卷调查.采用非条件多因素logistic回归分析探讨事故倾性发生的主要危险因素.结果 共筛查出事故倾性儿童147例,事故倾性的发生率为9.42%.单因素分析结果显示儿童性别(PPPPPPPPPOR=3.683,95%CI:1.028~4.283)、下等(OR=2.099,95%CI:1.587~8.546)、经济状况贫困(OR=2.353,95%CI:1.222~4.533)、教育方式放任或漠不关心(OR=1.914,95%CI:1.029~3.559)和变化无常(OR=4.153,95%CI:1.847~9.338)是儿童事故倾性的危险因素,女孩(OR=0.539,95%CI:0.369~0.788)是儿童事故倾性的保护因素.结论 学习成绩差、家庭经济贫困、教育方式放任或漠不关心和变化无常会增加农村儿童事故倾性的发生;相对于男孩,女孩事故倾性的发生较低.     

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??Objective??To study the family burden of children with thalassemia and their family members in Guizhou province. Methods??Family burden scale of disease??FBS?? and basic situation questionnaire were used to investigate 114 family members of children with thalassemia aged 0??14 who were diagnosed and treated in the Department of Pediatric Hematology and Oncology??Affiliated Hospital of Guizhou Medical University??from December 2016 to April 2018.
Results??The total score of FBS of family members of children with thalassemia was ??21.53±7.89??. The standardization scores of each dimension from high to low were family economic burden ??1.389±0.330????family entertainment activities ??0.914±0.530????family relationship ??0.807±0.530????mental health of family members??0.680±0.570????daily activities of the family ??0.679±0.390?? and physical fitness of family members ??0.442±0.440??. Univariate analysis??t/F test showed that the diagnosis typing of children with thalassemia??iron overload??medical insurance and monthly family income were the main factors affecting FBS??P??0.05??. Multivariate linear regression analysis showed that the effect of diagnostic typing??medical insurance??and monthly family income on FBS was statistically significant??P??0.05??. Conclusion??The family burden of children with thalassemia is widespread. It’s time that effective measures should be take to slove the problem according to family burden situation and its influencing factors.     

儿童哮喘吸入激素治疗后的随访观察

目的　探讨吸入糖皮质激素不同疗程患儿的预后。方法　将 81例轻度病例与 76例中、重度病例分别随机分为半年组与 1年组。吸入二丙酸倍氯松剂量为轻度每日 (2 0 0～ 6 0 0 ) μg ,中、重度每日 (40 0～ 80 0 ) μg。半年组疗程为症状控制后 6个月 ,1年组疗程为症状控制后 12个月。于停药后半年及 1年时进行哮喘复发情况的随访并作比较 ,同时观察不良反应。结果　 81例轻度哮喘半年复发率 :半年组 30 .2 3% ,1年组 13.16 % (P >0 .0 5 ) ;1年复发率 :半年组 5 1.16 % ,1年组 2 3.6 8% (P <0 .0 5 )。 76例中、重哮喘半年复发率 :半年组 34 .2 9% ,1年组 14.6 3% (P <0 .0 5 ) ;1年复发率 :半年组 6 5 .71% ,1年组 2 4.39% (P <0 .0 1)。两组患儿停药后均未见明显的不良反应。结论　吸入糖皮质激素治疗哮喘 ,尤其是中、重度哮喘 ,采用 1年疗程复发率低 ,较半年疗程为优 ,并且未见明显不良反应。     

癫癎儿童心理状态及影响因素的调查研究

目的评估癫癎儿童的心理状态,分析影响癫癎儿童心理状态的可能因素。方法采用儿少心理健康量表(MHS-CA)对113例癫癎儿童和114例正常儿童进行心理状态评定及比较。癫癎组儿童填写患儿一般情况和癫癎病情及治疗情况调查表。正常对照组儿童填写儿童一般情况调查表。分析影响癫癎儿童心理状态的可能因素。结果癫癎儿童在认知、思维、情绪、意志行为、个性特征上的心理健康状态均低于对照组儿童,差异有统计学意义(P0.05)。多因素logistic回归分析显示家庭教育方式、家庭关系、癫癎发作频率、癫癎发作持续时间、近6个月EEG癎样放电、抗癫癎药物使用种数为影响癫癎儿童心理状态的危险因素。结论癫癎儿童较正常儿童存在更广泛的心理健康问题。家庭生活环境差、癫癎控制不佳及多种抗癫癎药物应用是影响癫癎儿童心理状态的危险因素;改善家庭生活环境,尽量控制癫癎发作及使用单药治疗有助于改善癫癎患儿心理状态。     

糖尿病酮症酸中毒患儿氧化应激状况及影响因素分析

目的 探讨糖尿病酮症酸中毒(DKA)患儿血清氧化应激指标的变化及其与代谢参数的相关性.方法 将受试者分为4组:即DKA组22例;血糖控制一般组18例,糖化血红蛋白(HbAlc)＜9%;血糖控制较差组(HbAlc≥9%)22例;健康对照组36例.检测其血清丙二醛(MDA)、一氧化氮(NO)、谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)水平,并常规检测空腹血糖、血气、血清离子(K+,Na+,Cl-,P)、肾功能、尿常规、HbAlc.结果 DKA组血清MDA水平显著高于健康对照组(P＜0.01)及血糖控制一般组(P＜0.01),但与血糖控制较差组差异无显著性(P＞0.05);3组糖尿病患儿血清NO水平均显著高于健康对照组(P＜0.01),且血糖控制较差组NO显著高于血糖控制一般组(P＜0.01);3组糖尿病患儿血清GSH-Px水平均显著低于健康对照组(P＜0.01);4组间SOD水平差异无显著性(P＞0.05).相关分析显示糖尿病患儿血清MDA水平与HbAlc呈极显著正相关(r=0.375,P＜0.01),NO与HbAlc呈显著正相关(r=0.250,P＜0.05),DKA患儿血清SOD水平与HbAlc呈显著负相关(r=-0.507,P＜0.05),其他氧化应激指标与代谢参数问无相关性.结论 DKA患儿氧化应激产物显著增加,抗氧化能力降低,这些改变主要应归因于慢性高血糖而不是急性代谢紊乱.