肾上腺素联合布地奈德交替雾化吸入治疗急性喉炎合并喉梗阻的疗效及安全性(1)

http://www.100md.com 2016年4月15日 《中国现代医生》 2016年第11期

     [摘要] 目的 探讨肾上腺素联合布地奈德交替雾化吸入治疗急性喉炎合并喉梗阻的疗效及安全性。 方法 选取2014年2月～2015年2月期间我院收治的60例急性喉炎合并喉梗阻患儿，按随机数字法将其分为观察组和对照组，每组30例。观察组采用肾上腺素联合布地奈德交替雾化吸入治疗，对照组采用布地奈德雾化吸入治疗，比较两组临床症状消失时间及住院时间、临床疗效及不良反应。 结果 观察组与对照组相比，声嘶[(13.9±1.3)h vs (20.3±1.8)h]、呼吸困难[(3.2±1.1)h vs (5.7±1.3)h]、喉鸣音[(11.5±1.4)h vs (17.7±1.6)h]的症状消失时间及住院时间[(28.7±2.5)h vs (48.3±2.8)h]各项指标差异有统计学意义(P<0.05)；观察组治疗总有效率为96.7%，对照组为80.0%，两组总有效率差异具有统计学意义(P<0.05)；两组均未观察到明显不良反应。 结论 采用肾上腺素联合布地奈德交替雾化吸入治疗急性喉炎合并喉梗阻，对改善患者的临床症状及体征效果显著，可以明显提高临床治疗效果，无明显不良反应，安全性好，值得临床推广。

    [关键词] 肾上腺素；布地奈德；雾化吸入；急性喉炎；喉梗阻

    [中图分类号] R767.11 [文献标识码] B [文章编号] 1673-9701(2016)11-0086-03

    [Abstract] Objective To investigate the efficacy and safety of epinephrine combined with budesonide alternate aerosol inhalation in the treatment of acute laryngitis associated with laryngeal obstruction. Methods Sixty children with acute laryngitis associated with laryngeal obstruction treated in our hospital from February 2014 to February 2015 were divided into the control group(budesonide aerosol inhalation treatment) and the observation group(epinephrine combined with budesonide alternate aerosol inhalation treatment) according to the random number method， with 30 patients in each group. The clinical symptom disappearance time， length of stay， clinical efficacy and adverse reactions of the two groups were compared. Results The observation group and the control group were different in the disappearance time of hoarseness [(13.9±1.3) hours vs (20.3±1.8) hours]， dyspnea [(3.2±1.1) hours vs (5.7±1.3) hours] and throat singing song [(11.5±1.4) hours vs (17.7±1.6) hours] and the length of stay [(28.7±2.5) hours vs (48.3±2.8) hours]， with statistically significant differences(P<0.05). The total treatment effective rate of the observation group was 96.7%， which was significantly higher than the 80.0% of the control group， with statistically significant difference(P<0.05). No obvious adverse reaction occurred in either group during the treatment period. Conclusion Epinephrine combined with budesonide alternate aerosol inhalation can significantly improve the clinical symptoms and signs of the patients with acute laryngitis associated with laryngeal obstruction， can improve the clinical efficacy and has high treatment safety， thereby worthy of clinical promotion.

    [Key words] Epinephrine； Budesonide； Aerosol inhalation； Acute laryngitis； Laryngeal obstruction

    急性喉炎作为儿科比较常见的疾病之一，多由细菌或病毒感染所致[1，2]，其发生可能与患儿喉部及声门下区黏膜下组织松弛、喉软骨发育不完善、喉腔狭小、免疫力低下、淋巴血管相对丰富、咳嗽反射的排痰能力差等因素有关[3，4]，一旦发生感染就容易出现肿胀，造成上气道梗阻现象，患儿出现缺氧、缺血症状，甚至危及生命[5]。因此，采用足量有效的抗生素以迅速改善喉梗阻是治疗急性喉炎的关键[6，7]。然而在既往的临床治疗中，常用药物地塞米松、强的松等虽能起到消炎作用，但副作用较大[8，9]。本研究中，选择2014年2月～2015年2月期间我院急性喉炎合并喉梗阻患儿，采用肾上腺素联合布地奈德交替雾化吸入的治疗方法，临床效果显著，现报道如下。(苏丹 潘晓倩)

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