不同装置雾化吸入治疗在婴幼儿急性喘息性疾病中的对比研究

Comparison of treatment in acute wheezing of children under 3 years old with different inhalation devices

目的比较不同雾化装置吸入治疗在婴幼儿急性喘息性疾病中的效果及影响因素。方法将185例3个月～3岁急性喘息性疾病患儿随机分为压力定量式气雾剂＋储雾罐治疗组（P组）、雾化器治疗组（N组）、口服沙丁胺醇治疗组（对照组，C组），雾化吸入药物均为糖皮质激素加短效β2受体激动剂（沙丁胺醇），观察各组的显效率、有效率及P组和N组雾化治疗的依从性和不良反应情况，并使用Logistic回归分析来探讨雾化治疗效果的影响因素。结果P组和N组显效率均高于对照组；P组和N组雾化治疗效果及依从性无显著性差异，不良反应均较少；哮喘预测指数阳性及雾化治疗依从性高可能是疗效的保护性因素。结论压力定量式气雾剂＋储雾罐及雾化器雾化吸入糖皮质激素联合短效β2受体激动剂治疗婴幼儿急性喘息性疾病均安全有效，选择治疗方案时要关注哮喘预测指数及依从性。

Objective To evaluate the effect of different inhalation devices on acute wheezing of children under 3 years old and its in- fluencing factors. Methods A total of 185 children with acute wheezing, whose age were 3 months to 3 years old, were randomly divided into pressured metered dose inhalers with spacers group （P group）, nebulizers group （N group） and oral salbutamol group （control group, C group）. Aerosolized drugs were glucocorticoid combined with short-acting β2 receptor agonist（salbutamol）. The obvious effective rate and effec- tive rate in 3 groups, and compliance and adverse reaction to inhalation treatment in P group and N group were observed. The influencing fac- tors affecting the effect of inhalation treatment were explored with Logistic regression analysis. Results The obvious effective rate in P group or N group was significantly higher than that of C group; there were no significant differences in effect and compliance of P group and N group, and there were less adverse reaction in P group and N group; positive asthma prediction index and high compliance to inhalation treatment prob- ably indicated a good effect. Conclusion Inhaled glucocorticoid combined with short-acting β2 receptor agonists with pressured metered dose inhalers with spacers or nebulizers is safe and effective in treating acute wheezing of children under 3 years old. Compliance to inhalation device and asthma prediction index may be important influencing factors affecting the effect of inhalation treatment.