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目的评价大剂量甲基强的松龙联合丙种球蛋白治疗毛细支气管炎并呼吸衰竭的疗效与安全性。方法选择毛细支气管炎并呼吸衰竭80例。随机分为治疗组40例,对照组40例。两组患儿均采用抗病毒、按需吸入普米克加博利康尼,湿化气道,吸痰保持呼吸道通畅,合并细菌感染予以头孢类抗生素抗炎,血管活性药物等综合抢救。两组均给予人血丙种球蛋白400mg/(kg.次),共用5d。治疗组在上述治疗基础上加用大剂量甲基强的松龙冲击治疗,剂量2～3mg/kg.次,2次/d～3次;对照组未采用甲基强的松龙治疗。临床观察喘息、气促、紫绀、肺部哮鸣音及痰鸣音等症状缓解情况、血气分析动态检测及住院日。结果治疗组40例中显效24例,有效11例,总有效35例(87.5%)。对照组40例中显效5例,有效23例,总有效19例(70%)。治疗组显效率及总有效率明显高于对照组,差异有统计学意义(P<0.05)。结论大剂量甲基强的松龙联合丙种球蛋白治疗毛细支气管炎并呼吸衰竭的疗效显著
Objective To evaluate the efficacy and safety of high-dose methylprednisolone combined with gamma globulin in the treatment of bronchiolitis and respiratory failure. Methods Select bronchiolitis and respiratory failure in 80 cases. Randomly divided into treatment group 40 cases, control group 40 cases. Two groups of children were treated with antiviral drugs, inhaled pulmicort and bucconic as needed, humidified airway, suction to keep the airway clear, combined with bacterial infection to cephalosporins antibiotics, vasoactive drugs and other comprehensive rescue. Both groups were given human blood gamma globulin 400mg / (kg times), share 5d. The treatment group was treated with methylprednisolone at a dose of 2 ~ 3mg / kg, twice / d ~ 3 times on the basis of the above treatment. The control group was not treated with methylprednisolone. Clinical observation of wheezing, shortness of breath, cyanosis, lung wheezing and phlegm and other symptoms, blood gas analysis dynamic detection and hospitalization days. Results The treatment group of 40 cases markedly effective in 24 cases, effective in 11 cases, total effective 35 cases (87.5%). Control group 40 cases markedly effective in 5 cases, effective in 23 cases, total effective in 19 cases (70%). The effective rate and total effective rate of the treatment group was significantly higher than that of the control group, the difference was statistically significant (P <0.05). Conclusion The efficacy of high-dose methylprednisolone combined with gamma globulin in the treatment of bronchiolitis and respiratory failure is significant