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目的观察糖皮质激素联合异丙托溴铵、特布他林雾化吸入治疗毛细支气管炎的疗效,探讨不同疗程吸入糖皮质激素对毛细支气管炎预后的影响。方法将108例收治住院的毛细支气管炎患儿随机分为3组,均采用综合治疗。治疗1组予布地奈德混悬液联合特布他林、异丙托溴铵三联雾化吸入治疗7d,继续丙酸氟替卡松雾化吸入治疗至12周;治疗2组予布地奈德混悬液联合特布他林溶液二联雾化吸入治疗7d;对照组单用特布他林溶液雾化吸入治疗7d。观察3组患儿临床症状消失时间、住院天数,并进行临床疗效评定及追踪停药1a为喘息性疾病患病人数及患病率。结果治疗1组和治疗2组在咳嗽、喘憋症状缓解、肺部哮鸣音消失时间及缩短住院天数方面均优于对照组(Pa<0.05),治疗1组在临床缓解率方面较治疗2组更具优势(P<0.05)。治疗1组在停药1a喘息性疾病患病率明显降低,与对照组比较差异有统计学意义(P<0.05),治疗2组在停药1a喘息性疾病患病率与对照组比较稍低,但无显著性差异(P>0.05)。结论糖皮质激素联合特布他林二联雾化吸入治疗毛细支气管炎疗效肯定,糖皮质激素联合特布他林、异丙托溴铵三联雾化吸入治疗毛细支气管炎,对急性期症状的缓解优势更为明显,毛细支气管炎患儿吸入性糖皮质激素早期干预治疗至12周,可降低发展为支气管哮喘的几率。
Objective To observe the curative effect of glucocorticoid combined with ipratropium bromide and terbutaline on aerosol inhalation in the treatment of bronchiolitis and to explore the effect of inhaled glucocorticoid in different courses on the prognosis of bronchiolitis. Methods 108 cases of bronchiolitis admitted to hospital were randomly divided into three groups, all using comprehensive treatment. Treatment group 1 budesonide suspension combined with terbutaline, ipratropium bromide inhalation triple therapy for 7 days, continue to fluticasone propionate inhalation therapy until 12 weeks; treatment group 2 budesonide suspension In combination with terbutaline solution, inhalation was administered for 7 days, and control group was treated with inhalation of terbutaline solution for 7 days. The disappearance time and days of hospitalization were observed in three groups of children, and the clinical efficacy was evaluated and the withdrawal was stopped. The number and prevalence of asthma was prevalence. Results The treatment group 1 and the treatment group 2 were better than the control group in relieving cough and wheezing symptoms, reducing the time of lung wheezing and shortening the length of hospital stay (P0.05). The treatment group 1 had better clinical remission rate than the treatment 2 Group more advantage (P <0.05). The prevalence of asthmatic disease in treatment group 1 was significantly lower than that in control group (P <0.05), and the prevalence of asthmatic asthma in treatment group 2 was slightly lower than that of control group , But no significant difference (P> 0.05). Conclusions Glucocorticoid combined with Terbutaline in combination with nebulized inhalation for the treatment of bronchiolitis has definite effect. Glucocorticoid combined with Terbutaline and Ipratropium bromide inhalation therapy for bronchiolitis relieved the symptoms of acute phase The advantage is more obvious, early intervention of inhaled corticosteroids in children with bronchiolitis to 12 weeks, can reduce the risk of developing bronchial asthma.