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目的:分析雾化吸入疗法(AIT)对1～6个月婴儿急性毛细支气管炎的利弊。方法:将305例急性毛细支气管炎患儿按随机数表法分为雾化组166例和对照组139例,两组综合治疗方案按临床路径执行,雾化组给予布地奈德混悬液氧气驱动雾化吸入,每次0.5～1 mg,每日3～4次,每次10 min,对照组不用雾化吸入疗法,评价临床疗效及住院治疗第一个24 h内患儿喘憋、肺部啰音情况,观察治疗过程中喘憋消失时间、肺部啰音消失时间、需要吸氧例数及其平均吸氧时间。结果:在住院治疗第一个24 h内,雾化组喘憋加重46例(27.71%),肺部啰音加重59例(35.54%);对照组喘憋加重21例(15.11%),肺部啰音加重16例(11.51%),两组比较差异有统计学意义(P<0.01)。需要吸氧例数雾化组51例(30.72%),对照组43例(30.93%),两组比较差异无统计学意义(P>0.05);平均吸氧时间雾化组(2.39±0.72)d,对照组(2.41±0.69)d,两组比较差异无统计学意义(P>0.05);需要机械通气的例数雾化组9例(5.42%),对照组4例(2.88%),两组比较差异无统计学意义(P>0.05);喘憋消失时间雾化组(2.79±0.81)d,对照组(3.01±1.01)d,两组比较差异有统计学意义(P<0.05);啰音消失时间雾化组(7.58±1.83)d,对照组(6.07±1.62)d,两组比较差异有统计学意义(P<0.01);有效率雾化组57.83%,对照组56.11%,两组比较差异无统计学意义(P>0.05);住院时间雾化组(6.56±2.01)d,对照组(6.17±2.12)d,两组比较差异无统计学意义(P>0.05)。结论:AIT可以减轻急性毛细支气管炎患儿的临床症状,但不能缩短病程;小婴儿和重症患儿要注意治疗初期的治疗矛盾现象及治疗后期所引起的痰液不易消失情况;呼吸困难缓解后应及时停用,过度应用有害无益。
OBJECTIVE: To analyze the advantages and disadvantages of atomizing inhalation therapy (AIT) for acute bronchiolitis in infants aged 1 to 6 months. Methods: A total of 305 patients with acute bronchiolitis were divided into atomization group (n = 166) and control group (n = 139) according to random number table. The two groups were treated according to the clinical route. The atomization group was given budesonide suspension oxygen Driven aerosol inhalation, each 0.5 ~ 1 mg, 3 to 4 times a day, each 10 min, the control group without inhalation therapy, evaluation of clinical efficacy and hospitalization within 24 hours of first child wheezing, lung Department of rales, observe the disappearance of wheezing treatment time, pulmonary rales disappear time, the need for oxygen and the average number of oxygen inhalation time. Results: In the first 24 h of hospitalization, 46 patients (27.71%) had wheezing and 59 patients (35.54%) had pulmonary rales, 21 patients (15.11%) had wheezing in control group, lung Department of rales aggravated 16 cases (11.51%), the difference between the two groups was statistically significant (P <0.01). There were 51 cases (30.72%) in the aerosolization group and 43 cases (30.93%) in the control group, there was no significant difference between the two groups (P> 0.05); mean oxygen inhalation time (2.39 ± 0.72) d, and control group (2.41 ± 0.69) d, there was no significant difference between the two groups (P> 0.05); the number of cases needing mechanical ventilation was 9 cases (5.42%) in the atomization group and 4 cases (2.88% There was no significant difference between the two groups (P> 0.05). There was significant difference between the two groups (P <0.05) in the disappearing time of asthma group (2.79 ± 0.81) d and the control group (3.01 ± 1.01) (P <0.01). The effective rate was 57.83% in the nebulized group and 56.11% in the control group, and the difference was statistically significant between the two groups (P <0.01) There was no significant difference between the two groups (P> 0.05). There was no significant difference between the two groups in the length of hospitalization (6.56 ± 2.01) d and the control group (6.17 ± 2.12) d (P> 0.05). Conclusion: AIT can reduce the clinical symptoms of children with acute bronchiolitis, but can not shorten the course of the disease; young infants and critically ill children should pay attention to the contradiction between the treatment of early treatment and the sputum caused by the latter part of the treatment is not easy to disappear; Should be promptly disabled, over-use harmful.