布地奈德联合甲泼尼龙治疗小儿急性喉炎伴喉梗阻疗效观察

目的:探讨布地奈德联合应用甲泼尼龙或地塞米松治疗小儿急性喉炎伴喉梗阻的疗效差异。方法:选择2006年1月～2010年6月诊治的185例急性喉炎伴喉梗阻患儿,随机分为布地奈德联合甲泼尼龙(B+M组)95例和布地奈德联合地塞米松(B+D组)90例,比较两组患儿的疗效、症状体征消失时间、住院时间和费用的差异。结果:B+M组患儿治愈89例(93.7%),好转6例(6.7%),B+D组治愈75例(83.3%),好转15例(16.7%),两组间的差异有统计学意义(P=0.047)。两组患儿治疗前的症状和体征评分无明显差异(P>0.05),治疗后均显著降低(P<0.05),B+M组患儿评分较B+D组低(P<0.05)。B+M组患儿症状体征消失时间、平均住院时间和费用均显著少于B+D组(P<0.05)。两组患儿治疗后均无死亡病例,对雾化吸入耐受,无咽部刺激和支气管痉挛等不良反应,治疗后血压的差异无统计学意义(P>0.05)。结论:布地奈德联合甲泼尼龙可迅速缓解急性喉炎伴喉梗阻患儿症状体征,减少住院时间和费用,疗效显著高于联合应用地塞米松。

Curative effect of budesonide combining with methylprednisolone or dexamethasone on acute laryngitis complicated by laryngemphraxi

Objective： To compare the curative effects of budesonide combining with methylprednisolone or dexamethasone on acute laryngitis complicated by laryngemphraxis.Methods： A total of 185 children with acute laryngitis complicated by laryngemphraxis were randomly assigned into B＋M group（95 cases） and B＋D（90 cases） group,which was treated with budesonide combining with methylprednisolone and budesonide combining with dexamethasone,respectively.Curative effect,time for disappearance of signs and symptoms as well as cost of hospitalization were compared between the two groups.Results： Cases of complete remission and partial remission were 89（93.7%） and 6（6.7%） in B＋M group respectively,while the corresponding number was 75（83.3%） and 15（16.7%） for B＋D respectively,showing significant difference between the two groups（P=0.047）.No significant difference in scores of symptoms and clinical signs between the two groups was observed before treatment（P〉0.05）,while after treatment,the scores of B＋M group were significant lower than the B＋D group after treatment（P〈0.05） though decrease was observed in both groups.B＋M group also showed shorter hospitalization length,shorter time for disappearance of symptoms and clinical signs than B＋D group（P〈0.05）.Death occurred in neither group.No significant difference in changes of blood pressure,resistance to inhalation therapy,pharynx reactive or tracheospasm was observed between the two groups（P〉0.05）.Conclusions： Budesonide combined with methylprednisolone could rapidly relieve symptoms and signs of acute laryngitis complicated by laryngemphraxis in children with shorter time and less expenditure.Its curative effect was significantly better than that of budesonide combining with dexamethasone.