3%高渗盐水联合布地奈德、异丙托溴铵、沙丁胺醇雾化吸入治疗小儿喘息临床研究

Clinical Studies of 3% Hypertonic Saline Combined with Budesonide,Ipratropium Bromide and Salbutamol for Treating Asthmatic Disease in Children

目的：探讨3%高渗盐水（10%NaCl 0.6 mL＋灭菌注射用水1.4 mL）联合布地奈德、异丙托溴铵、沙丁胺醇雾化吸入治疗小儿喘息性疾病的疗效,为临床治疗提供参考。方法：选取我院喘息性疾病（毛细支气管炎、喘息性肺炎）住院患儿213例,按入院顺序随机分成治疗组109例和对照组104例。在常规治疗基础上,治疗组用布地奈德、异丙托溴铵、沙丁胺醇溶于3%高渗盐水2 mL雾化吸入,对照组则将上述药物溶于生理盐水2 mL雾化吸入,3次/天,疗程5~7 d。观察两组患儿入院后72 h临床严重性评分（CS）、咳嗽缓解时间、喘息缓解时间、肺部体征消失时间、住院时间、住院费用及不良反应。结果：两组患儿治疗后均痊愈出院,治疗组入院后72 h CS低于对照组（P〈0.05）,咳嗽及喘息缓解时间、肺部啰音消失时间、住院时间均短于对照组（P均〈0.05）。两组住院费用及不良反应比较差异无统计学意义（P〉0.05）。结论：在常规治疗基础上,用布地奈德、异丙托溴铵、沙丁胺醇溶于3%高渗盐水雾化吸入治疗小儿喘息性疾病祛痰效果明显,能较快改善各种常见小儿喘息性疾病的症状、体征,缩短住院时间,无明显不良反应。

Objective ： To evaluate the clinical effect of atomization inhales hypertonic saline （ 10% NaC1 0.6 mL and sterile water for injection 1.4 mL） combined with budesonide, ipratropium bromide and salbutamol in the treatment of asthmatic disease in children, and to provide treatment evidence to clinicians. Methods： A total of 213 children with asthmatic disease （bronchiolitis, asthmatic pneumonia） were randomly divided into two groups by the sequence of admittance to hospital： a therapy group （n = 109） and a control group （n = 104 ）. In the therapy group, the children were administrated by inhalation with budesonide, ipratropium bromide and salbutamol dissolved in 2 mL of 3% hypertonic saline solution. While in the control group, the children were given the above mentioned suspensions dissolved in the same amount of saline. The two groups received inhalation for the base of routine therapy. Inhalation was repeated for three times every day until wheezing relieved. The clinical severity score （ CS ） of the two groups at 72 hours after admission, the disappearance time of coughing, wheezing and lung physical signs, the length and cost of hospitalization, and adverse reactions were observed. Results： The two groups of patients were fully discharged after treatment. Compared with the control group, the disappearance time of coughing, pulmonary wheezing sound, coarse rales and hospital stay were significantly shortened in the therapy group ; the clinical severity score at 72 hours after treatment in the therapy group was lower than that in the control group ; the difference was statistically significant （P〈0.05）. Conclusions： On the basis of the conventional treatment, 3% hypertonic saline combined with budesonide, ipratropium bromide and salbutamol showed obvious expectorant effect, which can relieve symptoms and signs quickly for children patients with asthmatic disease, shorten length of hospital stay without adverse reactions.