甲基强的松龙冲击治疗毛细支气管炎的疗效观察

A study on the efficacy of large-dose methylprednisolone in treating the bronchiolitis with impulsive therapy

目的 :观察大剂量甲基强的松龙冲击治疗小儿毛细支气管炎的疗效及副作用。方法 :毛细支气管炎患儿 77例 ,随机分为三组 :冲击组 (治疗 组 ) 2 9例 ,地塞米松组 (治疗 组 ) 2 1例 ,对照组 2 7例。 组在常规治疗基础上加用甲基强的松龙 2 0 m g/ (kg.d)加入 10 %葡萄糖溶液 10 0 m L～ 15 0 m L 静脉滴注 (8∶ 0 0 ) ,连用 3d; 组 :在常规治疗基础上加用地塞米松 0 .3m g/ (kg· d)～ 0 .5 mg/ (kg· d)静脉推注 ,每日一次 ,连用 3d～ 5 d。对照组常规综合治疗。结果在喘憋、哮鸣音消失天数、胸部 X线恢复天数、住院日缩短等方面治疗 组与 组、对照组比较差异均有非常显著意义 ,P<0 .0 1,体温恢复天数差异无显著性 ,P>0 .0 5。三组疗效比较 ,有效率分别为 10 0 %、95 .3%、81.4% ,有显著差异 ,P<0 .0 5。临床应用未见肾上腺皮质危象或反跳现象及其它副作用。结论

Objective:To study the efficacy of large-dose methylprednisolone in treating the bronchiolitis.Method:77 patients were divided randomly into the treatment groups Ⅰ (29),treatment groups Ⅱ(21),control groups(27).In group Ⅰ,20mg/(kg.d) methylprednisolone was used in 100mL～150mL 10% GS ivdrip(at eight clock in the morning) for 3 days on the basis of routine treatment.In group Ⅱ 0.3mg/(kg·d)～0.5mg/(kg·d) dexamethas one was used iv qd for 3 to 5 days on the basis of routine treatment.Routine treatment was used in control group.Result:The days in disappear of pant,wheezes,chest X-ray and hospitalization was shorter in group Ⅰ than group Ⅱ and control group.The difference was very significant ( P <0.01).There had no significant difference in afebrile time ( P >0.01).The total effective rate in three groups was 100%(group Ⅰ),95.3%(group Ⅱ),81.4%(control group).The difference was significant( P <0.05).No adrenocortical crisis or rebound phenomena or other side-effects were found in clinical.Conclusion:It was concluded that the use of methylprednisolone was effective and safe.