CAJ | 학술논문

目的：探讨氧气驱动雾化吸入布地奈德治疗小儿毛细支气管炎的临床疗效及其对肺功能的影响。方法选择2013年10月—2014年10月佛山市禅城区中心医院儿科收治的毛细支气管炎患儿73例，按照治疗方法不同分为对照组（n =36）和观察组（n =37）。两组患儿均给予抗感染、祛痰、维持电解质及酸碱平衡等常规治疗，观察组患儿在常规治疗基础上采用氧气驱动雾化吸入布地奈德治疗，两组患儿疗程均为7 d。比较两组患者症状及体征（咳嗽、喘憋、哮鸣音）消失时间、住院时间，治疗期间上呼吸道感染、气喘及下呼吸道感染次数，治疗前后肺功能〔第一秒用力呼气容积（ FEV1）、第一秒用力呼气容积占预计值百分比（ FEV1%）及用力肺活量占预计值百分比（FVC%）〕及血清肿瘤坏死因子α（TNF -α）和单核细胞趋化蛋白-1（MCP -1）水平。结果观察组患儿咳嗽、喘憋、哮鸣音消失时间及住院时间均短于对照组，上呼吸道感染、气喘及下呼吸道感染次数少于对照组（P <0.05）。两组患儿治疗前 FEV1、FEV1%及 FVC%比较，差异无统计学意义（ P >0.05）；治疗后观察组患儿 FEV1、FEV1%及FVC%大于对照组（P <0.05）。治疗前两组患儿血清 TNF -α和 MCP -1水平比较，差异无统计学意义（ P >0.05）；治疗后观察组患儿血清 TNF -α和 MCP -1水平低于对照组（P <0.05）。结论氧气驱动雾化吸入布地奈德治疗小儿毛细支气管炎的临床疗效确切，能有效改善患者临床表现、炎性反应及肺功能。
목적：탐토양기구동무화흡입포지내덕치료소인모세지기관염적림상료효급기대폐공능적영향。방법선택2013년10월—2014년10월불산시선성구중심의원인과수치적모세지기관염환인73례，안조치료방법불동분위대조조（n =36）화관찰조（n =37）。량조환인균급여항감염、거담、유지전해질급산감평형등상규치료，관찰조환인재상규치료기출상채용양기구동무화흡입포지내덕치료，량조환인료정균위7 d。비교량조환자증상급체정（해수、천별、효명음）소실시간、주원시간，치료기간상호흡도감염、기천급하호흡도감염차수，치료전후폐공능〔제일초용력호기용적（ FEV1）、제일초용력호기용적점예계치백분비（ FEV1%）급용력폐활량점예계치백분비（FVC%）〕급혈청종류배사인자α（TNF -α）화단핵세포추화단백-1（MCP -1）수평。결과관찰조환인해수、천별、효명음소실시간급주원시간균단우대조조，상호흡도감염、기천급하호흡도감염차수소우대조조（P <0.05）。량조환인치료전 FEV1、FEV1%급 FVC%비교，차이무통계학의의（ P >0.05）；치료후관찰조환인 FEV1、FEV1%급FVC%대우대조조（P <0.05）。치료전량조환인혈청 TNF -α화 MCP -1수평비교，차이무통계학의의（ P >0.05）；치료후관찰조환인혈청 TNF -α화 MCP -1수평저우대조조（P <0.05）。결론양기구동무화흡입포지내덕치료소인모세지기관염적림상료효학절，능유효개선환자림상표현、염성반응급폐공능。
Objective To investigate the clinical effect of oxygen - driven atomization inhalation of budesonide on bronchiolitis in children and its impact on lung function. Methods From October 2013 to October 2014,a total of 73 children with bronchiolitis were selected in the Central Hospital of Chancheng District,Foshan,and they were divided into control group (n = 36) and observation group( n = 37)according to different therapeutic methods. Children of both group were given conventional treatment,including anti - infection,eliminating phlegm,maintaining balance of electrolyte and acid - base, while children of observation group were given extra oxygen - driven atomization inhalation of budesonide,both groups treated for 7 days. Disappeared time of clinical symptoms and signs( including cough,wheezes and wheezing rale),hospital stays, occurrence times of upper respiratory tract infection,short of breath and lower respiratory tract infection during treatment,lung function index(including FEV1 ,FEV1% and FVC% )and serum level of TNF - α and MCP - 1 before and after treatment were compared between the two groups. Results Disappeared time of cough,wheezes and wheezing rale,and hospital stays of observation group were statistically significantly shorter than those of control group,occurrence times of upper respiratory tract infection,short of breath and lower respiratory tract infection during treatment of observation group were statistically significantly less than those of control group( P < 0. 05). No statistically significant differences of FEV1 ,FEV1% or FVC% was found between the two groups before treatment(P > 0. 05),while FEV1 ,FEV1% and FVC% of observation group were statistically significantly higher than those of control group after treatment(P < 0. 05). No statistically significant differences of serum levels of TNF - α or MCP - 1 was found between the two groups before treatment(P > 0. 05),while serum levels of TNF - α and MCP- 1 of observation group were statistically significantly lower than those of control group after treatment(P < 0. 05). Conclusion Oxygen - driven atomization inhalation of budesonide has certain clinical effect on bronchiolitis in children,can effectively relieve the clinical symptoms and signs,inflammatory reaction,improve the lung function.