氨溴特罗口服液佐治毛细支气管炎的临床体会

目的评价氨溴特罗口服液治疗毛细支气管炎的疗效。方法106例1个月～2岁毛细支气管炎患儿随机分为2组治疗组56例,对照组50例观察治疗前后临床症状体征的变化。结果氨溴特罗口服液治疗7d后在缓解气促、咳痰、咳嗽持续时间、口罗音消失,缩短住院天数明显优于对照组。总有效率高于对照组(P<0.01)。结论氨溴特罗口服液改善毛细支气管炎的症状体征、总有效率优于对照组。且具有口感好,不良反应轻等特点。     

氨溴特罗口服液治疗毛细支气管炎的疗效观察

毛细支气管炎是婴幼儿时期常见呼吸道疾病，多由呼吸道合胞病毒引起，其临床主要表现为突发咳嗽、喘憋。有明显的毛细支气管阻塞现象，是儿科常见的急重症。目前治疗主要为抗病毒、支气管扩张剂、肾上腺皮质激素等治疗。解除呼吸道阻塞、改善通气、控制喘憋是提高毛细支气管炎疗效的关键。我们用氨溴特罗口服液治疗200例毛细支气管炎患儿取得了较好的疗效，现报道如下。     

氨溴特罗口服液改善支气管炎患儿呼吸道症状临床疗效观察

目的评估氨溴特罗口服液在临床上用于治疗支气管炎患儿的咳嗽、痰液黏稠、排痰困难、哮鸣音等临床表现的疗效及安全性。方法117例8个月至10.5岁患急性支气管炎、支气管炎伴喘息儿童,随机分为治疗组(氨溴特罗口服液)和对照组(盐酸氨溴索糖浆)。观察两组治疗前、治疗后1、3、5d咳嗽、痰液黏稠、排痰困难、哮鸣音评分及综合评分变化。结果治疗组、对照组治疗后咳嗽、痰液黏稠、排痰困难、哮鸣音均较治疗前明显减轻(P<0.05);治疗组治疗1、3、5d后缓解咳嗽症状、排痰困难症状、哮鸣音的有效率及缩短上述表现持续时间均优于对照组(P<0.05);在减少痰量与痰液黏稠持续时间上的疗效两组无显著性差异(P>0.05);治疗组治疗5d后呼吸道症状改善的总有效率高于对照组。结论氨溴特罗口服液对于改善支气管炎患儿的咳嗽、痰液黏稠、排痰困难、喘息等临床症状疗效显著。     

氨溴特罗口服液治疗婴幼儿支气管肺炎72例

目的评估氨溴特罗口服液治疗婴幼儿支气管肺炎的疗效。方法收集本院儿科2008年6月-2011年8月收治的婴幼儿支气管肺炎患儿83例。年龄0.5～37.0个月。随机分为治疗组42例和对照组41例。2组均采用综合治疗,治疗组口服氨溴特罗口服液,对照组服用盐酸氨溴索颗粒,观察2组患儿的疗效、肺部啰音改善情况及不良反应发生情况。结果治疗组显效18例(42.8%),有效20例(47.6%),无效4例(9.6%),总有效率为90.4%;对照组显效9例(22.2%),有效20例(50.0%),无效12例(27.8%),总有效率为72.2%。2组总有效率比较差异有统计学意义(P<0.05)。治疗组啰音消失时间为(6.1±2.4)d,对照组啰音消失时间为(8.4±2.7)d,2组比较差异有统计学意义(t=1.94,P<0.05)。对照组2例用药24 h出现皮疹,未处理自行消失;治疗组未发现明显不良反应。结论氨溴特罗口服液对改善婴幼儿支气管肺炎的临床表现较盐酸氨溴索颗粒显著。     

甲基强的松龙佐治毛细支气管炎疗效观察

毛细支气管炎 (毛支 )目前尚无特效的治疗方法。本文采用甲基强的松龙 (ＭＰＳＳ)佐治毛支患儿 ,取得良好疗效 ,现报道如下对象与方法一、临床资料　 1999年 9月～ 2 0 0 1年 9月我院住院的91例毛支患儿 ,均符合毛支诊断标准[1] ,入院前病程均不超过 2ｄ ,且未使用过肾上腺皮质激素 ,年龄为 2～ 18个月。随机分为ＭＰＳＳ治疗组 (Ａ组 ) 31例 ,男 19例 ,女 12例 ;必可酮组 (Ｂ组 ) 30例 ,男 17例 ,女 13例 ;氢化可的松组 (Ｃ组 ) 30例 ,男 19例 ,女 11例。二、方法　 3组均采用相同的综合治疗方法 ,如用干扰素抗病毒 ,吸氧、吸痰、镇静、经…     

干扰素雾化吸入佐治毛细支气管炎疗效观察

毛细支气管炎是儿童常见病，多发病，我院用干扰素雾化吸入佐治毛细支气管炎，收到了良好的效果，现报告如下。     

沐舒坦佐治毛细支气管炎疗效观察

目的观察沐舒坦静脉给药治疗毛细支气管炎效果。方法对确诊为毛细支气管炎66例患儿（2003年1月～2005年12月）随机分为治疗组和对照组各33例，治疗组行常规抗感染、对症、激素等治疗基础上，加用沐舒坦治疗观察。结果治疗组喘憋、气促、肺部哮鸣、痰鸣恢复情况明显优于对照组（P〈0．01）。结论沐舒坦静滴治疗毛细支气管炎疗效显著。     

川芎嗪佐治急性毛细支气管炎76例疗效分析

毛细支气管炎是婴儿期较常见的一种急性下呼吸道感染性疾病,起病较急。我科自1995年3月至1999年2月共收治此病112例。在基础治疗相同条件下,其中76例采用川芎嗪治疗,36例采用酚妥拉明加阿拉明治疗。现将治疗情况总结如下：     

沐舒坦佐治毛细支气管炎疗效观察

目的 观察沐舒坦静脉给药治疗毛细支气管炎临床疗效.方法 100例毛细支气管炎患儿随机分为治疗组和对照组(各50例),治疗组在常规抗感染、对症等治疗基础上加用沐舒坦治疗.结果 治疗组总有效率94.0%,对照组总有效率80.0%,两组总有效率比较差异有统计学意义(P<0.05).结论 沐舒坦静脉给药治疗毛细支气管炎临床疗效确切.     

Immunomodulatory constituents of human milk change in response to infant bronchiolitis

Although epidemiological evidence is generally supportive of a causal association between respiratory syncytial virus (RSV) bronchiolitis during infancy and the development of persistent wheeze/asthma, if not allergy, the mechanism by which this occurs and an explanation for why all children do not succumb remains to be elucidated. Breast feeding has been found to confer a protective effect against respiratory infections such as RSV bronchiolitis and allergy; however, again there is little direct evidence and no clear mechanism. In this study, we examined whether human milk immunomodulatory factors (cells, cytokines) change in response to clinically diagnosed, severe bronchiolitis in the recipient breast-fed infant. We examined milk from 36 breast feeding mothers of infants hospitalized with bronchiolitis and compared them with milk from 63 mothers of postpartum age-matched healthy controls. Milks from mothers of infants hospitalized with bronchiolitis had significantly greater numbers of viable cells when compared with the milks obtained from mothers of healthy infants (1.3 +/- 0.4 vs. 0.3 +/- 0.03 x 10(6) cells/ml, mean +/- s.e.m.; p < or = 0.001). Further, the cells obtained from the mothers of infants hospitalized with bronchiolitis were found to produce a skewed cytokine profile ex vivo in response to stimulation by live RSV but not when cultured with a non-specific mitogen (concanavalin A). This study provides preliminary evidence for an immunological link between mothers and their breast-fed infants during severe respiratory infections as well as a possible contributing factor to the development of persistent wheeze in these infants.     

吸入糖皮质激素预防呼吸道合胞病毒毛细支气管炎后反复喘息的临床观察

目的 观察吸入糖皮质激素能否预防呼吸道合胞病毒(RSV)毛细支气管炎(简称毛支)后反复喘息的发生.方法 选择2003年7月-2004年12月住院的RSV毛支患儿200例,入院后查外周血嗜酸性粒细胞、血清总IgE,血TH1/TH2水平及肺功能.毛支治愈后随机分为治疗组(100例)和对照组(100例),治疗组吸入布地奈德气雾剂3个月,对照组未给予治疗.3个月后随访,复查肺功能.停止治疗后继续观察2年,了解吸入激素3个月对患儿反复喘息发生的影响.结果 ①毛支治愈后的3个月内,治疗组无症状天数为(78.92±8.03)d,对照组为(74.83±9.54)d,两组比较差异有统计学意义(P＜0.01).②3个月后治疗组肺功能各项指标均比对照组明显好转(P＜0.05).③治疗组按吸入激素疗效分为毛支后喘息组和未再喘息组,这两组患儿入院时外周血嗜酸性粒细胞、血清总IgE、血Th1/Th2差异均有统计学意义(P＜0.05),而肺功能差异无统计学意义(P＞0.05).④停止治疗后2年两组患儿喘息再发比例差异无统计学意义(P＞0.05).结论 RSV毛支患儿治愈后吸入布地奈德气雾剂3个月,可改善肺功能.外周血嗜酸性粒细胞增多、血清总IgE升高、Th2功能亢进者,治疗期间可以减少毛支后喘息再发.吸入激素3个月不能减少停药后2年内喘息的发生.     

Double aortic arch presenting as severe bronchiolitis in a 2-week-old infant

A 2-week-old female infant was transferred from a regional hospital for mechanical ventilation after developing severe respiratory distress. Stridor had been present since the age of 1 week and was complicated by coryzal illness. Mechanical ventilation was difficult with marked inspiratory and expiratory flow obstruction recorded by the ventilator. Echocardiogram showed a normal heart. Flexible bronchoscopy revealed mid-tracheal extrinsic compression (unchanged with positive end-expiratory pressure) and advancement of the endotracheal tube by 2 cm completely corrected the flow obstruction. Repeat echocardiogram showed a double aortic arch. This case report emphasizes the importance of clinical history, examination findings and interpretation of the ventilator waveforms in the differential diagnosis of a difficult-to-ventilate infant with bronchiolitis.     

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??Acute infectious bronchiolitis could be caused by virus??bacteria??fungus and Mycoplasma pneumoniae with non-specific histology in children. Fever??cough and wheeze were the clinical manifestations??while centrilobular nodules??tree-in-bud and bronchiolar wall thickening were the main HRCT findings. The short-term prognosis was often good??although long-term prognosis was not optimistic with asthma and recurrent wheezing left. Since acute Mycoplasma pneumoniae bronchiolitis cases seemed to increase recently??it should be paid attention to by pediatrician.     

Acute viral bronchiolitis and its sequelae in developing countries

Acute viral bronchiolitis (AVB) is a common disease found throughout the world. Various aspects of it are being studied: its epidemiology, diagnosis, prognosis and treatment. Most of these studies are being conducted in developed countries, with only a few taking place in developing countries. Risk factors such as poor nutrition, an adverse environment and early weaning should be studied where these features are common. Treatment aspects such as cost-effectiveness in low income settings need further study. Use of ribavirin and respiratory syncytial virus (RSV)-immunoglobulin are good examples. Post-bronchiolitic sequelae also need to be studied in low income countries. There is evidence that bronchiolitis obliterans is unusually frequent in some Latin-American countries such as Argentina and Brazil. It will be helpful to undertake combined studies in countries with the same socio-economics, investigating the preventive and management aspects of AVB and its sequelae to reduce the morbidity and mortality.     

儿童肺炎支原体细支气管炎临床特点及预后研究

目的　探讨儿童肺炎支原体细支气管炎的临床特点及预后,提高对该病的认识。方法　对首都医科大学附属北京儿童医院呼吸二科病房2017年3月至2020年3月诊断的71例肺炎支原体细支气管炎患儿病例资料进行回顾性分析。结果　（1）71例患儿起病中位年龄6.6岁,均有咳嗽表现;97.2%（69/71）有发热,中位热峰39.4℃;36.6%（26/71）有喘息;39.4%（28/71）有低氧血症;81.7%（58/71）有过敏背景。（2）中位白细胞7.6×109/L,78.9%（56/71）C反应蛋白升高（15 mg/L）。仅40.8%（29/71）胸片提示网状结节影,71例肺部高分辨率CT（HRCT）均可见小叶中心结节、树芽征,35.2%（25/71）为弥漫性细支气管炎,38.0%（27/71）合并少量肺实变或者肺不张。8.5%（6/71）电子支气管镜检查可见广泛黏稠分泌物。（3）均予阿奇霉素治疗;98.6%（70/71）应用甲泼尼龙,单日最大量为1～6 mg/（kg·d）,首次应用时间中位病程为第10天,中位疗程为14 d。随访2.5～6.0个月,8.5%（6/71）发生闭塞性细支气管炎（BO）病情均为轻度;余91.5%（65/71）痊愈。（4）遗留BO患儿喘息、低氧血症、弥漫性细支气管炎的发生率明显高于未遗留BO者,P值分别为0.041、0.006和0.033。结论　肺炎支原体细支气管炎患儿多数有过敏背景。肺部HRCT表现为弥漫性病变,有喘息和低氧血症者,发生BO的可能性大。     

The chest radiograph in acute bronchiolitis

The relationship between clinical severity, as judged by a clinical scoring method, and the degree of radiological change on a chest X-ray, was assessed in 153 children with acute bronchiolitis. There was no statistical correlation between clinical severity and the degree of radiological change. The majority of radiographs were requested on the assumption that it was a useful routine investigation. We suggest that the request for a chest X-ray in acute bronchiolitis should be made only when the need for intensive care is being considered, where there has been an unexpected deterioration in the child's condition or the child has an underlying cardiac or pulmonary disorder.     

儿童感染后闭塞性细支气管炎研究进展

闭塞性细支气管炎(bronchiolitis obliterans,BO)是一种由严重小气道炎症损伤引起的少见的慢性气道阻塞性肺疾病。BO常见病因有感染、心肺或骨髓移植、吸入有毒物质、胃食管反流、结缔组织病及药物性等。儿童以感染后BO(post-infectious bronchiolitis obliterans,PIBO)最常见。文章综述PIBO研究进展。