论文部分内容阅读
目的：评价不同的预防方法对婴幼儿毛细支气管炎后反复喘息的预防效果。方法选取2009年1月至2012年1月期间常熟市第一人民医院收治的急性毛细支气管炎患儿201例，将其随机分成4组：氟替卡松组（45例）、孟鲁斯特组（56例）、酮替芬组（49例）、对照组（51例）。通过前瞻性研究具有反复喘息或哮喘高危因素的婴幼儿毛细支气管炎后第一次喘息后予以氟替卡松吸入、孟鲁司特钠、酮替芬口服13周及随后停药观察1年与对照组比较喘息发作情况、喘息时输液及全身糖皮质激素使用情况。结果经过13周干预，氟替卡松组、孟鲁斯特组喘息发作较对照组（P<0.01）及酮替芬组（P0.05）；氟替卡松组、孟鲁斯特组、酮替芬组较对照组静脉输液天数及全身激素使用天数少（P0.05），但静脉输液天数及全身糖皮质激素使用天数较对照组少（P<0.05），而酮替芬组尤为明显。因为药物副作用7例中断用药，仅占3.03%。结论对于毛细支气管炎后有反复喘息或哮喘高危因素的患儿，予以氟替卡松吸入或孟鲁斯特口服13周，可以减少干预期间的喘息发作及干预期、随后1年观察期喘息时的输液及全身糖皮质激素使用，酮替芬口服13周尽管不能减少干预期间的喘息发作，但能减少干预期及随后1年观察期的喘息时的输液及全身糖皮质激素使用。“,”ObjectiveTo evaluate the effect of different preventative measures on recurrent wheezing after bronchiolitis in infants and young children.MethodsThe infants and young children with high risk of recurrent wheezing or asthma and recovered from bronchiolitis were randomly assigned into four groups: fluticasone group(45 cases), montelukast group(56 cases),ketotifen group(49 cases) and non intervention group(51 cases).Inhaled fluticasone,oral montelukast and oral ketotifen were administered respectively to intervention groups for 13 weeks and the frequency of recurrent wheezing,the days of infusion and usage of systemic corticosteroid during wheezing attacks were observed during the course of medication and subsequent one year.ResultsAfter 13-weeks intervention, the frequency of recurrent wheezing were significant lower in fluticasone group and montelukast group than that in ketotifen group(P<0.05) and in non intervention group(P0.05). The days of infusion and usage of systemic corticosteroid during wheezing attacks were fewer in fluticasone group, montelukast group and ketotifen group than that in non intervention group (P<0.01),and fewer in montelukast group than that in ketotifen group (P0.05),but there were significant difference between intervention groups and non intervention group in the days of infusion and usage of systemic corticosteroid during wheezing attacks (P<0.05). The treatment were interrupted by side effect in seven children(3.03%). ConclusionThe infants and young children with high risk of recurrent wheezing or asthma and recovered from bronchiolitis administered inhaled fluticasone or oral montelukast for 13 weeks may reduce the frequency of recurrent wheezing during intervention and the days of infusion and usage of systemic corticosteroid during wheezing attacks will be reduced during intervention and the subsequent one year.