间歇雾化与连续雾化沙丁胺醇在急性重症哮喘患者的比较研究

Comparative Studies of Intermittent Atomization and Continuous Aerosolization of Salbutamol in Patients with Acute Severe Asthma

为了比较治疗急性重症哮喘时,沙丁胺醇连续雾化和间断雾化对临床和肺活量的影响,本研究对急性重症哮喘急诊科的42例患者随机分配,在6 h内以连续或间歇的雾化方式吸入27.5 mg的沙丁胺醇。连续雾化组在第1小时吸入15 mg沙丁胺醇,在接下来5 h吸入12.5 mg沙丁胺醇。间歇雾化组在第1小时里,每20 min吸入1次5 mg沙丁胺醇,在接下来5 h,每小时吸入2.5 mg沙丁胺醇。所有的参与者皆进行输氧,并静脉注射氢化可的松。在开始雾化的基线处、40 min、60 min、3h和6h,进行临床和肺活量的评估。在基线以上40 min时观察到2个小组显著的临床和肺活量改善,随后一直保持下去(在第6小时,连续和间歇雾化组绝对的PEF分别增加了(30±18)%和(32±22)%;在基线以上p<0.01)。两组中PEF和临床评分都有相似的进展。考虑到为了终止哮喘发作,连续雾化组(14%)和间歇雾化组(9.5%),绝对差异为4.5%[95%置信区间-14%~23%]而开展的最初的支气管扩张剂治疗,组间的失败比率没有差别。按照预先定义的标准(绝对差异4.8%[95%置信区间-24%~34%]),8个连续雾化组的患者(38%)和9个间歇雾化组的患者(43%)需要住院治疗。在急性严重哮喘症中,没有观察到连续和间歇的沙丁胺醇雾化过程明显的差异。

To compare the effect of continuous aerosolization and intermittent atomization of salbutamol on clinical and vital capacity in the treatment of acute severe asthma.The 42 patients in the acute severe asthma emergency department were randomly assigned to inhale 27.5 mg of salbutamol by continuous or intermittent nebulization within 6 hours.The continuous nebulizer group inhaled 15 mg salbutamol in the first hour and 12.5 mg salbutamol in the next five hours.Intermittent atomization group inhaled 5 mg of salbutamol every 20 minutes during the first hour and 2.5 mg of salbutamol per hour over the next 5 hours.All participants were given oxygenation and hydrocortisone was injected intravenously.Clinical and vital capacity assessments were performed at baseline,40 minutes,60 minutes,3 hours,and 6 hours,at which aerosolization was initiated.Significantly improved clinical and vital capacity was observed at 40 minutes above baseline,which was subsequently maintained(At the sixth hour,the absolute PEF of the continuous and intermittent spray groups increased by(30±18)%and(32±22)%,respectively,above baseline p<0.01).Both PEF and clinical scores have similar progress in both groups.Considering that in order to stop the asthma attack,the initial bronchiectasis was performed in the continuous nebulization group(14%),the intermittent nebulization group(9.5%),and the absolute difference was 4.5%(95%confidence interval-14%to 23%).In the treatment of the agent,there was no difference in the failure rate between the groups.Based on pre-defined criteria(absolute difference 4.8%(95%confidence interval-24%to 34%)),patients in the 8 consecutive nebulization groups(38%)and 9 patients in the intermittent nebulization group(43%)required hospitalization.In acute severe asthma,we did not observe significant differences in the continuous and intermittent salbutamol atomization process.The decision to use which of these methods should be considered from a logistical perspective.