乙酰半胱氨酸聯(lián)合丙酸倍氯米松霧化吸入治療毛細(xì)支氣管炎的臨床效果-1

PAGE/r/nPAGE/r/n8/r/n炎的臨床效果/r/n乙酰半胱氨酸聯(lián)合丙酸倍氯米松霧化吸入治療毛細(xì)支氣管炎的臨床效果/r/n史軍然杜杰靜高虹/r/n[摘要]目的探討乙酰半胱氨酸聯(lián)合丙酸倍氯米松霧化吸入治療毛細(xì)支氣管/r/n20XX/r/n2/r/n～20XX/r/n2/r/n306/r/nA/r/n（106例/r/nB/r/n（100/r/n）和對照組（100/r/n。所有患兒均給予常規(guī)治療措施。/r/nA/r/nB/r/nA/r/nB/r/nB/r/n（P0.05/r/n可縮短患兒的臨床癥狀消失時(shí)間，提高臨床治療效果，不良反應(yīng)少，安全性好，值得臨床推廣應(yīng)用。/r/n[關(guān)鍵詞]毛細(xì)支氣管炎;霧化吸入;乙酰半胱氨酸;丙酸倍氯米松[Abstract]ObjectiveToinvestigatetheclinicaleffectof/r/n/r/ninhalationofAcetylcysteinecombinedwithBeclomethasoneDipropionateinthetreatmentofcapillarybronchitis.MethodsAtotalof306patientswithcapillarybronchitistreatedinourhospitalfromFebruary20XXtoFebruary20XXwereselectedastheresearchsubjects.Accordingtothesequenceofelectronicmedicalrecords，theyweredividedintotreatment-Agroup/r/n/r/n（n=106/r/n，treatment-Bgroup/r/n/r/n（n=100/r/n，andcontrolgroup（n=100）.Allchildrenweregivenroutine/r/ntreatment.In/r/n/r/nthe/r/n/r/ntreatment-A/r/n/r/ngroup/r/n，/r/n/r/naerosol/r/n/r/ninhalation/r/n/r/nof/r/n/r/nAcetylcysteine/r/ncombinedwithBeclomethasoneDipropionatewasused.Inthetreatment-B/r/ngroup，/r/naerosol/r/ninhalation/r/nof/r/nSalbutamol/r/ncombined/r/nwith/r/nBeclomethasoneDipropionatewasused.Inthecontrolgroup，aerosolinhalationofSalbutamol/r/n/r/nalone/r/n/r/nwas/r/n/r/napplied./r/n/r/nThe/r/n/r/ndisappearance/r/n/r/ntime/r/n/r/nof/r/n/r/npanting，/r/nwheezingsoundandthreeconcavesignsinthethreegroupswascompared.Thetreatmenteffectandtheoccurrenceofadversereactionswereobserved.ResultsThedisappearancetimeofpanting，wheezingsoundandthreeconcavesignsinthetreatment-Agroupwasshorterthanthat/r/nofthetreatment-Bgroupandthecontrolgro/r/np/r/nthedisappearancetime/r/nofpanting，wheezingsoundandthreeconcavesignsinthetreatment-Bgroupwasshorterthanthatinthecontrolgroup，thedifferenceswerestatisticallysignificant（P0.05）.Noseriousadverse/r/nreactionsoccurredduringthetreatmentofthethreegroupsofchildren.ConclusionAerosolinhalationofAcetylcysteinecombinedwithBeclomethasoneDipropionateinthetreatmentofcapillarybronchitiscanshortenthedisappearancetimeofclinical/r/nsymptoms，/r/nimprovethe/r/nclinical/r/ntreatment/r/neffectinfewadversereactionsandgoodsafety，/r/nwhichis/r/nworthyof/r/nclinicalpromotionandapplication./r/n[Key/r/nwords]/r/nCapillary bronchitis; Aerosol inhalation;/r/nAcetylcysteine;BeclomethasoneDipropionate/r/n2/r/n2～6/r/n、聽診呼氣相延長、可聞及喘鳴、細(xì)濕啰音為主要臨床表現(xiàn);呼吸道合胞病毒/r/n（RSV）/r/n是引起毛細(xì)支氣管炎最常見的病原/r/n[1]。嬰幼兒呼/r/n危及生命[1]。如何迅速有效地控制緩解患兒急性期喘憋癥狀，減輕氣道炎癥反/r/n-3]霧化吸/r/n306/r/n資料與方法/r/n一般資料/r/n20XX/r/n2/r/n～20XX/r/n2/r/n306/r/nA/r/n（106/r/nB/r/n（100例）和對照組（100/r/nA/r/n64/r/n42/r/n3/r/n～2/r/nB/r/n56/r/n44/r/n3/r/n～2/r/n54/r/n46/r/n3/r/n～2/r/n（7.0±2.5）個(gè)月。三組患兒的性別、年齡等一般資料比較，差異無統(tǒng)計(jì)學(xué)意義/r/nP>0.05/r/n均知曉本研究情況并簽署知情同意書。/r/n[1];②/r/n3/r/n～2/r/n囊性纖維化患兒;④先天性氣道畸形患兒;⑤早產(chǎn)（孕齡/r/n方法/r/n三組患兒均給予常規(guī)監(jiān)測病情變化、對癥和支持等常規(guī)治療措施。/r/nA/r/n（規(guī)格：3/r/n/r/nml∶0.3/r/n/r/ng，Zambon/r/n/r/nS.P.A/r/n司，進(jìn)口藥注冊證號：Hxxxx，生產(chǎn)批號：xxxx/r/n，0.3g//r/n2/r/n氯米松（規(guī)格：2/r/nFarmaceutici/r/n證號：Hxxxx，生產(chǎn)批號：xxxx）治療，0.8mg//r/n2/r/nB/r/n（規(guī)格：2/r/nml∶2.5mg，上海信誼/r/nmg//r/n2/r/n對照組患兒給予沙丁胺醇霧化吸入治療。/r/n觀察指標(biāo)及評價(jià)標(biāo)準(zhǔn)/r/nA/r/nB/r/n（/r/n時(shí)間、肺部聽診喘鳴音消失時(shí)間、三凹征消失時(shí)間/r/n，觀察三組患兒的治療效果及不良反應(yīng)發(fā)生情況。/r/n7d/r/n7d/r/n[4]/r/n。治療總有效率/r/n=（治愈+顯效+有效）例數(shù)/總例數(shù)×100%。/r/n統(tǒng)計(jì)學(xué)方法/r/nSPSS/r/n19.0/r/nt/r/nχ2/r/nP/r/n結(jié)果/r/n三組患兒喘息、喘鳴音及三凹征消失時(shí)間的比較/r/n三組患兒的喘息、喘鳴音及三凹征消失時(shí)間比較，差異有統(tǒng)計(jì)學(xué)意義（P/r/n三組患兒治療總有效率的比較/r/n治療A組患兒的治療總有效率高于治療B組和對照組，差異均有統(tǒng)計(jì)學(xué)意義/r/nP0.05/r/n（/r/n2/r/n。/r/n三組患兒的不良反應(yīng)發(fā)生情況/r/n三組患兒治療過程中未發(fā)生嚴(yán)重不良反應(yīng)。3討論/r/n2/r/nRSV/r/n質(zhì)的患兒，反復(fù)喘息發(fā)作，有發(fā)展成為嬰幼兒哮喘的可能/r/n[5-7]。霧化療法具有重要意義[8-9]。霧化吸入治療具有作用直接、迅速，操作簡便，患兒無痛苦，/r/n（/r/n地奈德和丙酸倍氯米松/r/n、支氣管擴(kuò)張劑（吸入用異丙托溴銨、硫酸沙丁胺醇、硫酸特布他林/r/n霧化用祛痰藥有吸入用乙酰半胱氨酸和氨溴索[10]。/r/nβ2/r/n[11-14]，是目前兒童喘息性疾病首/r/n78.0%，臨床效果不理想。/r/nB/r/n[16]。本研究結(jié)果顯示，使用丙酸倍氯/r/nB/r/nB/r/n（/r/nP0.05/r/nA/r/n（/r/n-SH）直接打斷黏液糖蛋白中的雙硫鍵/r/n（/r/nS-S/r/n，破壞/r/n（GSH）/r/n水平，依/r/nGSH/r/nA/r/nB/r/n（P/r/n值得臨床推廣應(yīng)用。/r/n[參考文獻(xiàn)]/r/n識/r/n20XX/r/n）[J].中華兒科雜志，20XX，53/r/n3/r/n：168-171./r/n胡波.鹽酸氨溴索聯(lián)合布地奈德治療小兒支氣管肺炎的臨床療效及其對C/r/n反應(yīng)蛋白和白細(xì)胞計(jì)數(shù)的影響[J]./r/n70./r/n氣管肺炎的療效研究[J].山西醫(yī)藥雜志，20XX/r/n46（23/r/n：2906-2907./r/n.NCPAP/r/n氣管炎臨床效果觀察[J].山東醫(yī)藥，20XX，57/r/n20/r/n：71-73./r/n因子水平的影響研究[J].中外醫(yī)學(xué)研究，20XX/r/n17（25/r/n：41-43./r/n25-/r/nD3/r/n氣管炎中的臨床意義[J].中國當(dāng)代醫(yī)藥，20XX，/r/n26（14/r/n：114-116./r/n[J].中國醫(yī)藥導(dǎo)報(bào)，20XX，15（18/r/n：72-7/r/n，91./r/n20XX/r/n）/r/n[J].臨床兒科雜志，20XX，3/r/n（2/r/n：95-107./r/n制定專家組.霧化吸入療法在呼吸疾病中的應(yīng)用專家共識/r/n[J]/r/n.中華醫(yī)學(xué)雜志，20X/r/n，96（34/r/n：2696-2708./r/n晉榮新，鄢毅/r/n.N-乙酰半胱氨酸與鹽酸氨溴索治療小兒支氣管肺炎的療效對比及其對免疫功能和臨床癥狀的影響[J]./r/n120./r/n伍祥胡，梁霞，凌潔萍.異丙托溴銨溶液、沙丁胺醇、布地奈德混懸液聯(lián)合霧化吸入治療小兒毛細(xì)支氣管炎的效果研究[J]./r/n3/r/n（4/r/n：114-115./r/n104/r/n[J].中國藥物與臨床，20X/r/n，18（6/r/n：1018-1020./r/nKose/r/nal.The/r/nefficacy/r/nof/r/nNebulizedSalbutamol/r/n，/r/nMagnesium/r/n/r/nSulfate/r/n，/r/nand/r/n/r/nSalbutamol/r/n/r/nMagnesium/r/n/r/nSulfatecombination/r/nin/r/nmoderate/r/nbronchiolitis[J].Eur/r/nJ/r/nPediat/r/nr/r/n20X/r/nX/r/n17/r/n（9/r/n：1157-1160./r/nCarsin/r/nal.Early/r/nhalt/r/nof/r/na/r/nrandomizedcontrolledstudywith3%HypertonicSalineinacutebronchiolitis[J].Respiration，20XX，94（3/r/n：251-257./r/n金英姬，張?明.對霧化吸入激素治療毛細(xì)支氣管炎的看法/r/n[J]./r/n20XX，98/r/n（/r/n8/r/n：591./r/n李權(quán)恒，安淑華，李金英，等.丙酸倍氯米松霧化治療毛細(xì)支氣管炎的/r/n[J].中國全科醫(yī)學(xué)，20XX，20（35/r/n：4438-4441./r/n宋宏玲.