糖皮质激素不同给药方式和剂量治疗小儿急性感染性喉炎的疗效

目的:探讨糖皮质激素不同给药方式和剂量治疗儿童急性感染性喉炎的疗效。方法:选取2016年6月至2019年6月我院收治的Ⅰ~Ⅲ度喉梗阻并急性感染性喉炎患儿240例,随机分为观察组和对照组各120例,两组均给予常规抗感染及对症支持治疗,观察组Ⅰ度、Ⅱ度喉梗阻患儿给予布地奈德雾化吸入,Ⅲ度喉梗阻患儿在布地奈德雾化吸入基础上给予大剂量地塞米松静脉注射;对照组Ⅰ度、Ⅱ度喉梗阻患儿给予常规剂量地塞米松静脉注射,Ⅲ度喉梗阻患儿在布地奈德雾化吸入基础上给予常规剂量地塞米松静脉注射。观察两组患儿临床症状缓解时间、不良反应发生情况及院内感染发生率。结果:治疗后,观察组呼吸困难、声嘶、吸气性喉鸣、犬吠样咳嗽缓解时间均短于对照组(P<0.05)。观察组Ⅰ度、Ⅱ度、Ⅲ度喉梗阻患儿治疗总有效率均高于对照组(P均<0.05)。两组不良反应发生率及院内感染率比较差异无统计学意义(P>0.05)。结论:Ⅰ度、Ⅱ度喉梗阻患儿给予布地奈德雾化吸入,Ⅲ度喉梗阻患儿在布地奈德雾化吸入基础上给予大剂量地塞米松治疗可更快地缓解临床症状,减少激素应用总量,且无明显不良反应,未增加院内感染发生率,值得临床推广应用。

Efficacy of Different Administration Methods and Doses of Glucocorticoid in the Treatment of Children with Acute Infectious Laryngitis

Objective: To explore the efficacy of different administration methods and doses of glucocorticoid in the treatment of children with acute infectious laryngitis. Methods: A total of 240 children with acute infectious laryngitis with grade Ⅰ to Ⅲ laryngeal obstruction admitted into our hospital from Jun. 2016 to Jun. 2019 were extracted to be randomly divided into the observation group and the control group, with 120 cases in each group. Both groups were given conventional anti-infection and symptomatic support treatment. In the observation group, children with grade Ⅰ and Ⅱ laryngeal obstruction were given budesonide nebulized inhalation, while children with grade Ⅲ laryngeal obstruction received high-dose dexamethasone intravenously based on budesonide nebulized inhalation. In the control group, children with grade Ⅰ and Ⅱ laryngeal obstruction were given regular-dose dexamethasone intravenously, and children with grade Ⅲ laryngeal obstruction received regular-dose dexamethasone intravenously based on budesonide nebulized inhalation. The relief time of clinical symptoms, adverse drug reactions and nosocomial infection of two groups were observed. Results: After treatment, the relief time of dyspnea, hoarseness, inspiratory stridor and barking cough in the observation group was shorter than that in the control group(P<0.05). The total effective rate of the observation group with grade Ⅰ, Ⅱ and Ⅲ laryngeal obstruction was higher than that of the control group(P<0.05). There was no significant difference in the incidence of adverse drug reactions and nosocomial infection between two groups(P>0.05). Conclusion: Budesonide nebulized inhalation for children with grade Ⅰ and grade Ⅱ laryngeal obstruction, high-dose dexamethasone on the basis of budesonide nebulized inhalation for children with grade Ⅲ laryngeal obstruction can relieve the clinical symptoms more quickly and reduce the total amount of hormone application, without significant adverse drug reactions and without increasing the incidence of nosocomial infection, which is worthy of clinical promotion.