婴幼儿毛细支气管炎的临床治疗研究

Clinical Treatment Research of Bronchiolitis in Infants and Young Children

摘要: 毛细支气管炎是婴幼儿时期常见的下呼吸道感染性疾病，主要由呼吸道合胞病毒(RSV)感染引起，临床以喘息、气促、三凹征为主要表现。通过系统分析近年国内外相关研究文献，总结该病的临床治疗方案及效果。目前治疗以支持性干预为主，包括氧疗、补液及呼吸道管理。药物治疗方面，支气管扩张剂(如沙丁胺醇)及糖皮质激素的应用存在争议，研究显示其疗效有限且存在个体差异；抗病毒药物(如利巴韦林)因副作用及成本效益问题不推荐常规使用。高渗盐水雾化可改善黏液清除，但需严格把握浓度与适应症。免疫疗法中，帕利珠单抗对高危患儿预防效果显著，而新型单克隆抗体展现出更优的临床应用前景。中西医结合疗法(如中药贴敷、推拿)在改善症状方面具有一定潜力，但需更多循证医学证据支持。未来研究应聚焦于抗病毒药物研发、免疫调节剂优化及精准化治疗策略探索，同时加强预防干预以减少疾病负担。

Abstract: Bronchiolitis is a common lower respiratory tract infectious disease in infants and young children, mainly caused by respiratory syncytial virus (RSV) infection. Clinically, it is mainly characterized by wheezing, shortness of breath and the three concave signs. By systematically analyzing the relevant research literature at home and abroad in recent years, the clinical treatment plans and effects of this disease are summarized. At present, the treatment is mainly supportive intervention, including oxygen therapy, fluid replacement and respiratory tract management. In terms of drug treatment, the application of bronchodilators (such as salbutamol) and glucocorticoids is controversial. Studies have shown that their therapeutic effects are limited and there are individual differences. Antiviral drugs (such as ribavirin) are not recommended for routine use due to side effects and cost-effectiveness issues. Hypertonic saline atomization can improve mucus clearance, but the concentration and indications need to be strictly controlled. In immunotherapy, Palivizumab has a significant preventive effect on high-risk children, while new monoclonal antibodies show better clinical application prospects. Integrated traditional Chinese and Western medicine therapies (such as traditional Chinese medicine application and massage) have certain potential in improving symptoms, but more evidence-based medical evidence is needed to support them. Future research should focus on the development of antiviral drugs, the optimization of immunomodulators and the exploration of precise treatment strategies, while strengthening preventive intervention to reduce the burden of diseases.