硫酸镁联合硫酸沙丁胺醇治疗小儿中-重度支气管哮喘急性发作的疗效  

Effect of nebulized magnesium sulfate combined with salbutamol in the treatment of moderate to severe asthma attacks in children

作　　者：翁蔚琪 谢文龙[2] 胡文辉[3] WENG Wei-qi;XIE Wen-long;HU Wen-hui(Department of Pediatrics, Taizhou Cancer Hospital, Taizhou, Zhejiang 317502, China)

机构地区：[1]台州市肿瘤医院儿科,浙江台州317502 [2]湖州市中心医院康复医学科,浙江湖州313000 [3]台州医院儿内科,浙江台州317000

出　　处：《中华全科医学》2018年第9期1479-1482,共4页Chinese Journal of General Practice

基　　金：浙江省医药卫生科技计划项目(2016KYA170)

摘　　要：目的评价在小儿中-重度支气管哮喘急性发作的治疗中应用硫酸镁联合硫酸沙丁胺醇雾化吸入的临床疗效及安全性。方法将2015年1月—2017年1月台州市肿瘤医院收治的99例中-重度支气管哮喘急性发作患儿随机分为硫酸镁(33例)、沙丁胺醇组(33例)和联合应用组(33例),在常规治疗基础上,分别给予硫酸镁、沙丁胺醇和硫酸镁联合沙丁胺醇雾化吸入,比较治疗前后的FEV1、PEF及FEV1%和PEF%、临床疗效、治疗情况和不良反应发生率。结果治疗后,3组患者FEV1和PEF绝对值以及FEV1和PEF占预计值的百分比具有明显增长,其中联合应用组的改善幅度最大,沙丁胺醇组次之,硫酸镁组最小。硫酸镁组、沙丁胺醇组和联合应用组的治疗总有效率分别为66.67%、69.70%和93.94%,联合应用组明显高于硫酸镁组和沙丁胺醇组(P<0.016 7);硫酸镁组和沙丁胺醇组的总有效率间差异无统计学意义(P>0.016 7)。联合应用组患儿的总住院时间、机械通气和ICU留治率以及治疗时间均显著低于硫酸镁组和沙丁胺醇组(均P<0.05);硫酸镁组的总住院时间、机械通气和ICU留治率以及治疗时间均显著高于沙丁胺醇组(P<0.05)。硫酸镁组、沙丁胺醇组和联合应用组的不良反应率间差异无统计学意义(12.12%、9.09%和18.18%,均P>0.05)。结论在小儿中-重度支气管哮喘急性发作的治疗中应用硫酸镁联合硫酸沙丁胺醇雾化吸入具有较好的疗效,能够显著改善肺功能,降低机械通气的使用率,且安全性较好。Objective To evaluate the effect and safety of nebulized magnesium sulfate （MgSO4） combined with al- buterol sulfate in the treatment of moderate to severe asthma attacks in children. Methods Ninety-nine children with a- cute attack of bronchial asthma were randomized into three groups ： MgSO4 nebulization （ group M）, salbutamol nebuliza- tion （group S） , and combination （group M ＋ S）. The aerosol inhalation based on the routine treatment was performed in all groups. The FEV1, PEF, FEV1% and PEF% , clinical efficacy, time of mechanical ventilation and ICU treatment, hospital stay and the incidence of adverse reactions were compared among the three groups. Results After the treat- ment, the absolute values （FEV1 and PEF） and the predicted percentage （FEVI% and PEF% ） in all the three groups were significantly increased, among which the improvement of the group M ＋ S was the largest, followed by the group S, and the group M were the smallest. The total effective rates of group M, group S and group M ＋ S were 66.67% , 69.70% and 93.94%, the effective rate of group M ＋ S was significantly higher than those of group S and group M （P 〈0. 016 7 ）, but no significant difference between group S and group M （P 〉 0.016 7 ）. The hospitalization time, the use rate and use time of mechanical ventilation and ICU treatment were significantly lower in the group M ＋ S than group M and group S （ P 〈 0.05 ）. There were no significant differences in the treatment-related adverse effects rates three groups （ 12.12%, 9.09% and 18.18%, P 〉 0.05 ）. Conclusion In the treatment of moderate to severe asthma attacks in children, the use of magnesium sulfate combined with salbutamol sulfate inhalation has a better effect and good safety, can significantly improve lung function, and reduce the use of mechanical ventilation.

关 键 词：支气管哮喘急性发作 硫酸镁 沙丁胺醇 肺功能 儿童 

分 类 号：R562.25[医药卫生—呼吸系统] R725.6[医药卫生—内科学]