甲泼尼龙结合临床干预路径治疗小儿哮喘性支气管炎的临床效果及对症状改善时间的影响

The effect of methylprednisolone combined with clinical intervention pathway on the clinical efficacy and symptom improvement time of pediatric asthmatic bronchitis

目的探讨甲泼尼龙结合临床干预路径治疗小儿哮喘性支气管炎临床疗效及对症状改善时间的影响。方法选取杭州市第一人民医院从2018年2月—2023年2月206例肺炎患儿为研究对象,对其中103例患儿采用临床干预路治疗小儿哮喘性支气管炎作为对照组,在对照组的基础上采用甲泼尼龙药物进行配合治疗的103例患儿作为观察组。观察两组患儿治疗后肺功能改善情况、疗效、主要症状及体征平均消失时间、满意度调查情况及不良反应情况。结果治疗后,观察组肺功能改善率为94.17%,明显高于对照组的改善率79.61%;同时,观察组有效率为85.44%,明显高于对照组的有效率98.06%,差异有统计学意义(χ^(2)=9.590,P<0.05)。观察组患儿的呼吸困难消失、喘息消失、哮鸣音消失及咳嗽消失时间短于对照组[(3.37±1.27)d vs.(1.69±1.41)d,(4.63±1.57)d vs.(2.57±1.73)d,(5.52±2.24)d vs.(3.68±1.32)d,(7.82±1.94)d vs.(5.74±1.37)d],差异均有统计学意义(均P<0.05)。治疗后,观察组患儿的满意度为99.03%,优于对照组满意度83.50%,差异有统计学意义(P<0.05)。治疗后,对照组患者免疫系统异常3例、代谢和营养障碍1例、心脏异常4例、关节疼痛4例及眩晕1例,对照组患者免疫系统异常4例、代谢和营养障碍2例、心脏异常2例、关节疼痛2例及眩晕1例,两组患儿不良反应差异均无统计学意义(χ^(2)=0.148,0.338,0.687,1.845,0.338,均P>0.05)。结论甲泼尼龙结合临床干预路径是小儿哮喘性支气管炎有效的治疗方案,可临床推广。

Objective To explore the effect of methylprednisolone combined with clinical intervention pathway on the clinical efficacy and symptom improvement time of pediatric asthmatic bronchitis.Methods A total of 206 children with pneumonia were selected from Hangzhou First People's Hospital from February 2018 to February 2023 over a period of 5 years.103 cases of pediatric asthma bronchitis were treated with clinical intervention as the control group,while the other 103 cases were treated with methylprednisolone in combination with the control group as the observation group.Observe the improvement of lung function,efficacy,average disappearance time of main symptoms and signs,satisfaction survey,and adverse reactions of two groups of children after treatment.Results After treatment,the improvement rate of lung function in the observation group was 94.17%,significantly higher than the improvement rate of 79.61%in the control group;At the same time,the effective rate of the observation group was 85.44%,significantly higher than the effective rate of the control group of 98.06%,and the differences were statistically significant(χ^(2)=9.590,P<0.05).The observation group showed a shorter disappearance time of dyspnea,wheezing,wheezing,and cough compared to the control group[(3.37±1.27)d us.(1.69±1.41)d,(4.63±1.57)d vs.(2.57±1.73)d,(5.52±2.24)d us.(3.68±1.32)d,(7.82±1.94)d us.(5.74±1.37)d],and the differences were statistically significant(P<0.05).After treatment,the satisfaction rate of the observation group's children was 99.03%,which was better than the control group's satisfaction rate of 83.50%,and the differences were statistically significant(P<0.05).After treatment,there were 3 cases of immune system abnormalities,1 case of metabolic and nutritional disorders,4 cases of cardiac abnormalities,4 cases of joint pain,and 1 case of dizziness in the control group;There were 4 cases of immune system abnormalities,2 cases of metabolic and nutritional disorders,2 cases of cardiac abnormalities,2 cases of joint pain,and 1 case of dizziness in the observation group.The number of adverse reactions in the two groups was almost the same,and the difference was not statistically significant(χ^(2)=0.148,0.338,0.687,1.845,0.338,P>0.05).Conclusion The combination of methylprednisolone and clinical intervention pathway is an effective treatment plan for pediatric asthmatic bronchitis,which can be clinically promoted.