两种吸入给药方案治疗婴幼儿喘息性支气管炎疗效比较

The therapeutic effect comparison of two treatment methods for inhalation in infant asthmatic bronchitis

目的比较两种吸入给药方案治疗婴幼儿喘息性支气管炎的临床疗效。方法将212例喘息性支气管炎患儿用Excel生成随机数法分为A组103例和B组109例，均给予抗感染、补液等常规治疗。A组在常规治疗基础上给予布地奈德1mg、特布他林5mg加入2ml0．9％氯化钠氧气驱动雾化吸入治疗，每次15min，2～4次／d；B组给予硫酸沙丁胺醇气雾剂（每揿100μg）1～4揿，每次15S，4—6次／d，丙酸氟替卡松吸入气雾剂（每揿125μg）1～2揿，每次15S，2次／d，结合面罩式储雾罐吸入治疗。两组疗程5—7d，观察治疗效果。结果A、B两组治疗3d后总有效率分别为92．2％（95／103）和97．2％（106／109），两组比较差异无统计学意义（x2=2．73，P〉0．05）。B组咳嗽、喘息、哮鸣音缓解时间、住院时间短于A组[（12．00±2．75）h比（29．00±1．25）h、（10．00±1.45）h比（31．00±2．75）h、（13．00±1．55）h比（33．00±2．33）h、（7．20±0．65）d比（8．70±1．35）d]，住院费用少于A组[（2．00±0．30）千元比（2．50±0．55）千元]，差异均有统计学意义（P〈0．05）。结论与特布他林联合布地奈德方案相比，沙丁胺醇联合氟替卡松方案治疗婴幼儿喘息性支气管炎，具有起效迅速、疗效确切、住院时间短、费用低、依从性好、便于调整等优点，值得基层医院推广应用。

Objective To compare the therapeutic effect in two kinds of inhalation in infant asthmatic bronchitis. Methods Two hundred and twelve asthmatic bronchitis children were randomly divided into group A （103 eases） and group B （109 cases）. The children in two groups were treated with conventional therapy, including antibiotics, fluids and other treatment. The children in group A were given budesonide 1 mg, terbutaline 5 mg plus 0.9% sodium chlorine in 2 ml, with oxygen driven inhalation therapy, 2 -4 times/d. The children in group B were given albuterol sulfate inhalation aerosol 1 -4 spray/times, 4 -6 times/d, inhaled fluticasone quantitative aerosol spray 1 -2 spray/times, 2 times/d, 15 s/times. The course of two groups was 5 - 7 d. The therapeutic effect was compared. Results The total effective rate in group A and group B were 92.2% （95/103） and 97.2% （106/109）,there was no significant difference （ x2 = 2.73, P 〉 0.05 ）. The relieve time of cough, gasping and wheezing , hospital stay in group B were shorter than those in group A[ （ 12.00± 2.75 ） h vs. （29.00 ± 1.25 ） h, （ 10.00 ± 1.45 ） h vs. （31.00 ±2.75 ） h, （ 13.00±1.55 ） h vs. （ 33.00±2.33 ） h, （7.20 ± 0.65 ） d vs. （ 8.70 ± 1.35 ） d ], the cost of hospitalization in group B was lower than that in group A [ （2.00 ± 0.30） thousand Yuan vs. （2.50 ± 0.55 ） thousand Yuan ], there were significant differences（P 〈 0.05 ）. Conclusions The albuterol inhalation solution combined with fluticasone has the advantages of rapid efficacy, short course, low cost, easy to accept and adjust. It is worth to spread in primary hospital.