甲泼尼龙联合布地奈德阶梯雾化治疗小儿急性喉炎合并喉梗阻的临床研究

Clinical study of methylprednisolone combined with budesonide ladder nebulization inhalation in the treatment of acute laryngitis complicated with laryngeal obstruction in children

目的研究对急性喉炎合并喉梗阻患儿应用甲泼尼龙联合布地奈德阶梯雾化治疗的临床疗效。方法82例急性喉炎合并喉梗阻患儿,按随机数字表抽取法分为观察组与对照组,各41例。对照组采用甲泼尼龙静脉注射治疗,观察组在对照组基础上联合布地奈德阶梯雾化治疗。比较两组临床症状消退时间及平均住院时间,治疗前后的血清炎症因子,临床疗效,不良反应发生情况。结果观察组声嘶消退时间(2.58±0.23)d、犬吠样咳嗽消退时间(0.45±0.26)d、喉鸣消退时间(2.46±0.62)d、呼吸困难消退时间(0.61±0.22)d、平均住院时间(4.58±0.43)d皆明显短于对照组的(2.76±0.44)、(1.72±0.43)、(2.82±0.41)、(1.75±0.26)、(6.86±0.56)d(P<0.05)。治疗后,两组C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)均较治疗前明显下降,且观察组CRP(5.20±0.93)mg/L、TNF-α(97.28±10.05)ng/ml、IL-6(35.61±6.11)pg/ml明显低于对照组的(9.55±1.23)mg/L、(128.02±9.89)ng/ml、(53.82±7.29)pg/ml(P<0.05)。观察组治疗总有效率97.56%明显高于对照组的80.49%(P<0.05)。治疗期间,两组不良反应发生率比较无统计学差异(P>0.05)。结论急性喉炎合并喉梗阻患儿应用甲泼尼龙联合布地奈德阶梯雾化治疗,可协同增效,迅速改善临床症状,控制和明显减轻炎症反应,缩短住院时间。

Objective To investigate the clinical efficacy of methylprednisolone combined with Budesonide ladder atomization in the treatment of children with acute laryngitis complicated with laryngeal obstruction.Methods 82 children with acute laryngitis and laryngeal obstruction were divided into an observation group and a control group using a random number table extraction method,with 41 cases in each group.The control group was treated with intravenous injection of methylprednisolone.On this basis,the observation group was treated with budesonide ladder atomization.The clinical symptom resolution time,mean hospital stay,serum inflammatory factors before and after treatment,clinical efficacy and occurrence of adverse reactions were compared between the two groups.Results In the observation group,the trachyphonia resolution time was(2.58±0.23)d,the barking cough resolution time was(0.45±0.26)d,the laryngeal stridor resolution time was(2.46±0.62)d,the dyspnea resolution time was(0.61±0.22)d and the mean hospital stay was(4.58±0.43)d,which were significantly shorter than(2.76±0.44),(1.72±0.43),(2.82±0.41),(1.75±0.26)and(6.86±0.56)d in the control group(P<0.05).After treatment,the C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in both groups were significantly decreased compared with those before treatment;and the observation group had CRP of(5.20±0.93)mg/L,TNF-αof(97.28±10.05)ng/ml and IL-6 of(35.61±6.11)pg/ml,which were significantly lower than(9.55±1.23)mg/L,(128.02±9.89)ng/ml and(53.82±7.29)pg/ml in the control group(P<0.05).The total effective rate of the observation group was 97.56%,which was significantly higher than 80.49%of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups during treatment(P>0.05).Conclusion The application of methylprednisolone combined with budesonide ladder atomization in the treatment of children with acute laryngitis and laryngeal obstruction can synergistically improve the clinical symptoms,control and significantly reduce the inflammatory reaction,and shorten the hospital stay.