小剂量阿奇霉素辅助治疗儿童闭塞性细支气管炎临床疗效分析

Low-Dose Azithromycin in the Adjuvant Treatment of Children with Bronchiolitis Obliterans

目的:探讨小剂量阿奇霉素辅助治疗儿童闭塞性细支气管炎的临床疗效。方法:采用回顾性研究方法,收集2014年1月至2017年10月我院收治的确诊闭塞性细支气管炎患儿43例,根据治疗方法分为对照组27例和观察组16例。对照组给予常规治疗包括平喘、止咳、吸痰、吸氧等对症综合治疗,必要时应用激素及孟鲁司特钠;观察组在常规治疗基础上给予小剂量阿奇霉素(3～5 mg/kg,每日1次)口服,连用3 d停4 d为1个疗程,根据患儿病情可适当延长疗程。比较两组患儿的疗效和临床症状的改善情况。结果:对照组患儿总有效率为74. 07%,观察组为93. 75%,两组比较差异无统计学意义(P>0. 05)。观察组患儿的咳嗽、喘息、哮鸣音、湿啰音缓解时间均短于对照组(P均<0. 05)。两组患儿的不良反应发生率比较差异无统计学意义(P>0. 05)。结论:口服小剂量阿奇霉素可一定程度缓解闭塞性细支气管炎患儿的临床症状。

Objective: To investigate the clinical efficacy of low-dose azithromycin in the adjuvant treatment of children with bronchiolitis obliterans. Methods: Retrospective research method was adopted,43 children with bronchiolitis obliterans admitted into our hospital from Jan. 2014 to Oct. 2017 were extracted to be divided into the control group( n = 27) and the observation group( n = 16)via different treatment methods. The control group was given routine treatment including antiasthmatic,cough relieving,sputum aspiration,oxygen inhalation and other symptomatic comprehensive treatment,and hormone and monteluster sodium were applied when necessary. The observation group was treated with a low-dose azithromycin of 3-5 mg/kg on the basis of the conventional treatment,oral administration for once a day,the continuous application for 3 d and withdraws for 4 d was set as a course of treatment,the course of treatment can be appropriately extended according to the condition of the children. The efficacy and clinical symptoms of two groups were compared. Results: The total effective rate was 74. 07% in control group and 93. 75% in observation group,without any statistically significant difference( P >0. 05). The relieving time of cough,wheezing,wheezing rale and moist rale in observation group was shorter than that in control group( P<0. 05). There was no significant difference in the incidence of adverse drug reactions between two groups(P >0. 05). Conclusion: Oral low-dose azithromycin can alleviate the clinical symptoms of children with bronchiolitis obliterans.