小儿急性喉炎420例治疗总结

Treatment of 420 Cases of Acute Laryngitis in Children

目的 探讨小儿急性喉炎最佳治疗方案。方法 对我院1992—2002年10年来收治的小儿急性喉炎420例,进行回顾分析。结果 经大剂量激素及抗生素等治疗,374例(89％)12h内呼吸困难缓解,393例(93.6％)24h内呼吸困难缓解,413例(98.3％)48h内呼吸困难缓解,100％于5d内呼吸困难解除。气管切开2例占0.5％。无1例因短期应用大剂量肾上腺皮质激素发生毒副反应。结论 治疗小儿急性喉炎的关键是大量应用激素快速有效地解除呼吸困难并给予有效抗生素控制感染。激素用量为0.56～2.97mg/(kg·d),平均1.80mg/(kg·d)。配合大剂量有效抗生素、雾化吸入、吸氧等治疗,大大降低患儿窒息的危险及气管切开率。

Objective To probe into the best treatment scheme for acutelaryngitis in children. Methods To sum up and analyze the clinical data of the acute laryngitis in children between 1992 and 2002, and to compare the data with that treated by the routine treatment scheme and that by the treatment scheme we used before. Results 420 cases of a-cute laryngitis in children were treated by large doses of dexamethasone and antibiotics, and the dyspnea of 374 cases (89% ) was released in 12 hr, and the dyspnea of 393 casesreeased in 24 hr, and the dyspnea of 413 cases released in 48 hr, and the dyspnea of all patients released in S days. Tracheotomy was performed onlyin 2 cases (0.5% ). No toxic or side reaction because of application of largedoses of dexamethasone was found. Conclusion The key to acute laryngitis isto release dyspnea by large dose oi dexamethasone and to control infectionby effective antibiotics. The doses of dexamethasone used were between 0.56 mgikg. d and 2. 97 mg/kg · d with an average dose of 1 .80 mg/kg ·d. The risk of suffocation and the rate of tracheotomy were reduced significantly by theuse of large doses of dexamethasone and effective antibiotics and atomizedaspiration and oxygen therapy, therefore the course of disease was shoFtenedgreatly.