肾上腺素与布地奈德吸入治疗拔管后喉头水肿疗效比较

摘要

目的：探讨肾上腺素、布地奈德雾化吸入治疗气管插管患儿拔管后喉头水肿的疗效。方法回顾性分析124例重症肺炎行气管插管拔管后出现喉头水肿的患儿，根据拔管后主要治疗方法不同分为A组和B组，A组用氧气雾化吸入肾上腺素治疗喉头水肿，B组用氧气雾化吸入盐酸布地奈德治疗喉头水肿，观察两组喉头水肿症状持续时间、雾化后即刻动脉血气及雾化1h后呼吸频率和心率。结果 A组喉头水肿持续时间为（26．91±12．38） h，B组为（34．86±13．21） h，A组症状持续时间较B组短，两组比较，差异有统计学意义（t＝-2．691，P＜0．05）；A组雾化后即刻动脉血氧分压为（88．57±9．06）mmHg，B组为（76．81±11．03）mmHg，A组动脉血氧分压较B组高，两组比较，差异有统计学意义（t＝2．529， P＜0．05）；A组二氧化碳分压为（41．27±11．50）mmHg，B组为（62．21±11．31）mmHg，A组二氧化碳分压较B组低，两组比较，差异有统计学意义（t＝-5．529，P＜0．05）；雾化1h后A组呼吸频率为（34．32±7．79）次/min，B组为（41．18±7．76）次/min，A组呼吸频率较B组低，两组比较，差异有统计学意义（ t＝-3．899，P＜0．05）。结论氧气雾化吸入肾上腺素可以缩短喉头水肿症状持续时间，提高动脉血氧分压，降低二氧化碳分压，降低呼吸频率。%Objective To evaluate the efficacy of oxygen-driven aerosol inhalation of adrenaline and budesonide on children ’ s laryngeal edema after removing endotracheal intubation .Methods This study was conducted by a retrospective analysis .Totally 124 children with laryngeal edema after removing endotracheal intubation were divided into group A and B according to different treatment methods .Group A was treated by using oxygen-driven aerosol inhalation of adrenaline , while group B was treated by using oxygen-driven aerosol inhalation of budesonide .Evaluation indicators were observed in two groups , including the duration of laryngeal edema , arterial blood gas immediately after finishing atomization inhalation , respiratory rate and heart rate 1h after finishing atomization inhalation .Results The duration of laryngeal edema was 26.91 ±12.38 h and 34.86 ±13.21 h, respectively in group A and group B, and the difference was significant (t=-2.691,P<0.05).The PaO2 monitored immediately after finishing atomization inhalation was 88.57 ±9.06mmHg and 76.81 ±11.03 mmHg, respectively in group A and group B , and the difference was still significant ( t =2.529, P <0.05).The PaCO2 monitored immediately after finishing atomization inhalation in group A (41.27 ±11.50 mmHg) was lower than that in group B (62.21 ±11.31 mmHg) with significant difference (t=-5.529,P<0.05).The respiratory frequency was 34.32 ±7.79 in group A and 41.18 ±7.76 in group B.There was statistical significance in it (t=-3.899, P<0.05).Conclusion Oxygen-driven aerosol inhalation of adrenaline can shorten the duration of laryngeal edema , improve PaO2 , reduce PaCO2 and reduce respiratory frequency .