雾化吸入高剂量糖皮质激素对急性发作期儿童哮喘疗效的影响

摘要

目的：探讨雾化吸入高剂量糖皮质激素对急性发作期儿童哮喘疗效的影响。方法将本院儿科收治的93例哮喘儿童随机分为治疗组48例和对照组45例，2组均接受吸氧等常规治疗，在此基础上，治疗组雾化吸入高剂量糖皮质激素联合异丙托溴胺；对照组口服糖皮质激素激素片，并常规吸入异丙托溴胺。治疗前及治疗后1 h，密切监测2组患儿心率（HR）、呼吸频率（RR）、第1秒用力呼气容积（FEV1）、最大呼气流速（PEF）、血氧饱和度（SpO2）等临床指标，比较2组临床疗效，并观察不良反应发生情况。结果治疗组总有效率为97．9％，显著高于对照组的82．2％（P ＜0．05）。与治疗前比较，2组治疗后1 h HR、RR 明显减慢，FEV1、PEF 显著改善，且 SpO2明显增加，其中治疗组 HR、RR、FEV1、PEF 及 SpO2改善程度显著优于对照组（P ＜0．05或P ＜0．01）。治疗组不良反应总发生率12．5％（6/48），对照组为17．8％（8/45），2组差异无统计学意义（P ＞0．05）。结论对于急性发作期的哮喘儿童，雾化吸入高剂量糖皮质激素联合异丙托溴胺能快速缓解症状，改善肺功能，增加SpO2，且不良反应较轻。%Objective To investigate the effect of aerosol inhalation of high-dose glucocor-ticoids on children with asthma at acute attack stage.Methods Ninety-three asthmatic children re-ceived in our hospital were randomly divided into treatment group (48 cases)and control group (45 cases).Both groups were given routine treatment like oxygen uptake.Besides,the treatment group was treated with aerosol inhalation of high-dose glucocorticoids and ipratropium bromide,while the control group was given glucocorticoid tablets and routine inhalation of ipratropium bromide.Before and 1 h after treatment,the heart rate (HR),respiratory rate (RR),forced expiratory volume in 1 second (FEV1),peak expiratory flow (PEF)and SpO2 of children in both groups were strictly monitored,clinical efficacies were compared and adverse reactions were observed.Results The overall response rate of treatment group (9 7 .9 % )was significantly higher than control group (82.2%)(P <0.05),with statistical significant difference.Compared with treatment before,the HR and RR slowed down markedly,FEV1 and PEF were improved and SpO2 increased obviously in both groups 1 h after treatment,in which the improved degrees of all the above indexes in treatment group were superior to control group ,with statistical significant differences (P < 0 .0 5 ,or P <0.01).The total incidence rate of adverse reactions was 12.5% (6 /48)and the total incidence rate of control group was 17.8% (8 /45),and there were no significant differences between 2 groups (P>0.05).Conclusion For the asthmatic children at acute attack stage,aerosol inhalation of high-dose glucocorticoids and ipratropium bromide can rapidly alleviate symptoms,ameliorate the lung function and elevate SpO2,with milder adverse reactions.