硫酸镁不同静脉给药方法治疗婴儿重症毛细支气管炎疗效比较

Different Intravenous Administrations of Magnesium Sulfate in the Treatment of Severe Bronchiolitis in Infant

目的:探讨硫酸镁不同静脉给药方法治疗婴儿重症毛细支气管炎的疗效。方法:选取2016年在重庆三峡中心医院儿童重症医学科住院治疗,年龄1~12个月,符合重症毛细支气管炎诊断标准的患儿60例。按入院时间顺序随机分为对照组和观察组各30例。对照组患儿给予25%硫酸镁,每次25 mg/kg加入5%葡萄糖注射液稀释成1.25%浓度静脉滴注,每次2 h,2次/天,疗程5 d;观察组患儿给予25%硫酸镁25 mg/(kg·h)加入5%葡萄糖注射液稀释成5%浓度24 h持续静脉滴注,疗程5 d。观察两组患儿治疗后临床症状消失时间及治疗72 h血气分析指标,判定临床疗效。结果:观察组患儿哮鸣音、气促、咳嗽消失时间短于对照组,治疗72 h后观察组血气指标较对照组明显改善,差异有统计学意义(P<0.05)。观察组总有效率为96.67%,高于对照组的73.33%,差异有统计学意义(P<0.05)。治疗过程中两组患儿均未出现严重不良反应。结论:硫酸镁持续静脉滴注治疗婴儿期重症毛细支气管炎疗效明显,不良反应少,值得临床推广应用。

Objective： To investigate the therapeutic effect of different intravenous administrations of magnesium sulfate in the treatment of severe bronchiolitis in infants. Methods： A randomized clinical trial was conducted, sixty infants aged 1 to 12 months undergoing severe bronchiolitis were divided into control group and observation group, based on their hospitalization time. All children were treated in our hospital from January 2016 to December 2016. Children in control group received 25% magnesium sulfate, 25 mg/kg a time, adding 5% glucose diluted to 1.25% concentration of liquid intravenous drip, drip off in 2 hours, twice per day, 5 days for one period of treatment. While children in observation group received continuous 25% magnesium sulfate, 25 mg/（ kg · h） , adding 5% glucose diluted to 5% concentration of liquid intravenous drip, drip off in 24 hours, 5 days for one period of treatment. The time for eliminating the clinical symptoms, blood gas indexes after 72 hours of treatment were observed to evaluate the therapeutic effects. Results： The disappearance time of wheezing, anhelation and cough in observation group were significantly shorter than those in control group. After 72 hours of treatment, the blood gas indexes of observation group were significantly improved. There were statistically significant differences in two groups （P〈0.05）. The total effective rate of observation group was higher than that of control group, there was statistically significant difference between two groups （P〈0. 05 ）. No obvious adverse drug reaction was found in two groups during treatment. Conclusion： In the treatment of severe bronchiolitis in infants, continuous intravenous infusion of magnesium sulfate has the advantages of better curative effect and less adverse reactions. It is worthy of being recommended in clinical practice.