CAJ | 학술논문

目的：探讨糖皮质激素的不同给药方式对婴幼儿毛细支气管炎治疗效果的影响。方法89例毛细支气管炎患儿随机分成三组：实验Ⅰ组、实验Ⅱ组、实验Ⅲ组。三组实验对象在常规抗病毒、化痰及对症治疗的基础上,实验Ⅰ组给予甲泼尼龙琥珀酸钠静脉滴注；实验Ⅱ组给予丙酸氟替卡松定量气雾剂储雾罐辅助吸入；实验Ⅲ组给予布地奈德混悬液雾化吸入。对三组治疗疗效、主要症状及体征缓解和消失时间、治疗5d后临床评分进行比较分析。结果①三组患儿在主要症状缓解时间方面,除肺部湿啰音消失时间及住院天数实验Ⅱ组与Ⅲ组类似外(P>0.05),余症状实验Ⅲ组均短于Ⅰ、Ⅱ组(P<0.05)。②治疗效果Ⅲ、Ⅱ组均优于Ⅰ组(P<0.05)。③三组治疗后临床症状评分较治疗前评分均有所降低(P<0.05),Ⅲ组降低明显(P<0.05)。结论局部吸入糖皮质激素较全身用糖皮质激素在毛细支气管炎治疗过程中起效快,能有效缩短病程,不良反应小,更能提高治愈率。其中布地奈德混悬液氧气驱动雾化吸入更能缓解喘憋,缩短喘息及咳嗽持续时间,患儿易接受,易于推广。
목적：탐토당피질격소적불동급약방식대영유인모세지기관염치료효과적영향。방법89례모세지기관염환인수궤분성삼조：실험Ⅰ조、실험Ⅱ조、실험Ⅲ조。삼조실험대상재상규항병독、화담급대증치료적기출상,실험Ⅰ조급여갑발니룡호박산납정맥적주；실험Ⅱ조급여병산불체잡송정량기무제저무관보조흡입；실험Ⅲ조급여포지내덕혼현액무화흡입。대삼조치료료효、주요증상급체정완해화소실시간、치료5d후림상평분진행비교분석。결과①삼조환인재주요증상완해시간방면,제폐부습라음소실시간급주원천수실험Ⅱ조여Ⅲ조유사외(P>0.05),여증상실험Ⅲ조균단우Ⅰ、Ⅱ조(P<0.05)。②치료효과Ⅲ、Ⅱ조균우우Ⅰ조(P<0.05)。③삼조치료후림상증상평분교치료전평분균유소강저(P<0.05),Ⅲ조강저명현(P<0.05)。결론국부흡입당피질격소교전신용당피질격소재모세지기관염치료과정중기효쾌,능유효축단병정,불량반응소,경능제고치유솔。기중포지내덕혼현액양기구동무화흡입경능완해천별,축단천식급해수지속시간,환인역접수,역우추엄。
Objective To discuss the influence of different administration methods of glucocorticoid in the treatment of bronchiolitis in infants. Methods A total of 89 infants with bronchiolitis were divided into three groups randomly:groupⅠ, groupⅡand groupⅢ. All of the three groups were given the treatment of antiviral, eliminating phlegm, rehydration and other symptomatic treatment. GroupⅠwas given methylprednisolone sodium succinate by intravenous drip. GroupⅡwas given fluticasone propionate aerosol, inhaled by a spacer. GroupⅢwas given budesonide suspension through aerosol inhalation. The therapeutic effects, remission and disappearing time of the main clinical symptoms and physical signs, and the scores of the three groups after 5 days of treatment had been compared and analyzed. Results ①The similar disappearance time of lung rale and hospital stay (P>0.05), while the remission time for the main clinical symptoms of groupⅢwas shorter than the time of groupⅠand groupⅡ(P<0.05).②The therapeutic effects of groupⅢand groupⅡwere both better than the effect of groupⅠ(P<0.05).③Scores of the three groups after aerosol treatment are lower than scores before treatment (P<0.05), and the score of groupⅢshowed a significant reduction (P<0.05). Conclusion Topical inhalation of glucocorticoid takes effect faster on the treatment of bronchiolitis than systemic inhalation. Moreover it can effectively reduce the course, decrease adverse reaction and improve the cure rate. The oxygen-driven aerosol inhalation of budesonide suspension is more useful to remit dyspnoea, reduce the duration of wheeze and cough. It is easy to be accepted by infants and easy to be applied.