雾化吸入疗法在支气管哮喘急性发作治疗中的评价

Efficacy of Fog Inhalation Therapy in Treating Acute Episode of Bronchial Asthma

目的:探讨联合氧驱动雾化吸入沙丁胺醇雾化溶液、异丙托溴胺雾化吸入液、布地奈德混悬液对急性发作中、重度支气管哮喘的治疗作用。方法:将48例支气管哮喘患者随机分为对照组(22例)和治疗组(26例)。在其他常规治疗相同的基础上,治疗组加用生理盐水1mL+沙丁胺醇雾化溶液2mL+异丙托溴胺雾化吸入液2mL+布地奈德混悬液4mL经高流量氧气驱动每6h雾化吸入1次;对照组加用沙丁胺醇雾化溶液,每次2喷,每喷每次200μg,每6h1次。比较治疗3d后2组患者临床症状缓解率;比较2组患者治疗3h后和5d后第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、呼气峰值流速(PEF);比较2组患者治疗5d后血糖、动脉血气指标;比较患者全身使用激素时间和住院时间。结果:治疗3d后治疗组有效率(24/26)明显高于对照组(14/22),2组比较差异有显著性意义;治疗组经治疗3h后与对照组比较,FEV1、PEF数值有显著性差异,FVC无显著性差异,治疗组经治疗5d后与对照组比较,FEV1、FVC、PEF数值有显著性差异;治疗5d后治疗组与对照组比较,PaO2、PaCO2、血糖的数值均有显著性差异;2组患者全身使用激素的天数和住院天数比较有显著性差异。结论:中、重度支气管哮喘急性发作时,使用沙丁胺醇雾化溶液、异丙托溴胺雾化吸入液、布地奈德混悬液联合吸入治疗能取得良好疗效。

OBJECTIVE： To evaluate the therapeutic efficacy of oxygen - driven aerosol inhalation of Ventolin plus Atrovent and Budesonide suspension for acute episode of intermediate or severe degree of bronchial asthma. METHODS： A total of 48 patients with bronchial asthma were divided into two groups randomly： 26 cases in the treatment group received normal saline （1 mL） ＋ Ventolin （2 mL） ＋ Atrovent （2 mL） and Budesonide suspension（4 mL） q6 h in addition to the routinetherapy by high - flow oxygen driven in addition to the routine therapy; 22 cases in the control group received Ventolin inhaler（200 μg） q 6 h. The improvement of clinical symptoms in the two groups after treatment for 3 days, the forced expiratory volume in one second （FEV1）, forced vital capacity （FVC）, peak expiratory flow （PEF） at 3 h and 5 days, respectively, the blood sugar level, arterial blood gas index as well as duration of systemic use of hormone and the hospital days were compared between two groups. RESULTS： After treatment for 3 days, the effective rate in the treatment group（24/26） was significantly higher than in the control group （14/22）, showing significant differences between two groups. At 3 h, there were significant differences between the treatment group and the control group in FEV1 and PEF but not in EVC; at 5 days, there were significant dif- ferences between the treatment group and the control group in FEV1, FVC and PEF. On day 5, there were significant differences between two groups in PaO2, PaCO2 and blood sugar level as well as in the duration of systemic use of hormone and the hospital days. CONCLUSION： Aerosol inhalation of Ventolin plus Atrovent and Budesonide suspension shows remarkable therapeutic efficacy for acute episode of intermediate or severe degree of bronchial asthma.