糖皮质激素全身及局部应用治疗小儿毛细支气管炎疗效分析

An Analysis of Treatment Effect: Systemic and Local Application of Glucocorticoid in Children Bronchiolitis

摘要: 目的：观察全身及局部应用糖皮质激素治疗小儿毛细支气管炎的疗效，为临床治疗急性毛细支气管炎提供参考。方法：将155例诊断为毛细支气管炎患儿分成3组，对照组49例，给予化痰、吸氧、补液、抗病毒、抗感染及0.9% NaCl + 博利康尼雾化吸入治疗，治疗I组59例，在对照组基础上加用甲泼尼龙治疗，治疗II组47例，在对照组基础上加用普米克令舒雾化吸入治疗，观察3组临床症状缓解时间及外周血变化情况。结果：治疗I组和治疗II组喘憋缓解时间和住院时间分别为(3.13 ± 1.26) d、(10.70 ± 1.95) d和(3.13 ± 1.00) d、(10.34 ± 1.85) d，均短于对照组的(3.83 ± 1.22) d、(11.54 ± 2.09) d，差异有统计学意义(P < 0.05)；治疗I组发热持续时间(2.07 ± 1.59) d短于其他两组(2.95 ± 1.88) d、(3.55 ± 1.77) d，治疗II组咳嗽持续时间(8.89 ± 1.87) d短于其他两组(9.34 ± 2.09) d、(9.95 ± 2.30) d，差异均有统计学意义(P < 0.05)。治疗7天后，评价疗效，治疗I组、治疗II组和对照组治疗总有效率分别为93.2%、91.5%、87.8%。复查外周血白细胞及血小板，治疗I组血小板计数(511.39 ± 140.34) × 10⁹/L，明显高于治疗II组(329.91 ± 104.49) × 10⁹/L和对照组(317.58 ± 81.91) × 10⁹/L，治疗II组淋巴细胞计数(6.76 ± 1.89) × 10⁹/L高于治疗I组(5.05 ± 2.13) × 10⁹/L和对照组(4.77 ± 1.86) × 10⁹/L，差异均有统计学意义(P < 0.05)。结论：小剂量全身应用甲泼尼龙及局部雾化吸入普米克令舒治疗小儿毛细支气管炎效果好，安全性高，不良反应发生风险较低。

Abstract: Objective: Observe the effect of glucocorticoids used by systemic or local in the children suffering from bronchiolitis. Provide a reference for cure bronchiolitis. Methods: 155 cases diagnosed as bronchiolitis were divided into 3 groups. Control group in 49 cases, which was given conventional therapy: such as reduce phlegm, spply oxygen, fluid infusion, antivirus, antibiotics and aerosol inhalation by 0.9% NaCl + salbutamol. Treatment group I in 59 cases, added methyl prednisolone compared with the control group. Treatment group II in 47 cases, added Budesonide compared with the control group. Obseve the changes in clinical symptoms and peripheral blood of children in these 3 groups. Results: Times of asthma remission and hospitaization in treatment group I and treatment group II were (3.13 ± 1.26) days, (10.70 ± 1.95) days and (3.13 ± 1.00) days, (10.34 ± 1.85) days, which were shorten than control group’s ((3.83 ± 1.22) days, (11.54 ± 2.09) days), (P < 0.05). Duration of fever in treatment group I ((2.07 ± 1.59) days) was shorter than other groups ((2.95 ± 1.88) days, (3.55 ± 1.77) days), (P < 0.05). Duration of cough in treatment group II ((8.89 ± 1.87) days) was shorter than other groups ((9.34 ± 2.09) days, (9.95 ± 2.30) days), (P < 0.05). After 7 days of treatment, total effective rate in treatment group I, treatment group II and control group were 93.2%, 91.5%, 87.8%, respectively. Count of platelet in treatment group I ((511.39 ± 140.34) × 10⁹/L) was more than other groups (treatment group 2 (329.91 ± 104.49) × 10⁹/L, control group (317.58 ± 81.91) × 10⁹/L), (P < 0.05). Count of lymphocyte in treatment group II ((6.76 ± 1.89) × 10⁹/L) was more than other groups (treatment group I (5.05 ± 2.13) × 10⁹/L, control group (4.77 ± 1.86) × 10⁹/L), (P < 0.05). Conclusion: Small doses of methyl prednisolone and atomization inhalation have good effects, high safety and low risk.