A randomized clinical trial was conducted on young children with bronchiolitis admitted to hospital with moderate illness to determine the efficacy of the bronchodilators Salbutamol and ipratropium bromide, either as a single drug or in combination, given as a nebulized solution, compared with a normal saline placebo. Eighty-nine patients, aged from 23 days to 11 months, were randomized into four groups, depending on administered drug or placebo, as followsgroup 1--Salbutamol (n = 20); group 2--ipratropium bromide (n = 23); group 3--combined Salbutamol and Ipratropium bromide (n = 24); group 4--normal saline (n = 22). The groups were identical with respect to age, sex, family history of atopy, respiratory syncytial virus (RSV) positivity and enrollment score. They were scored using the clinical parameters of wheezing, retractions and respiratory rate at enrollment, at 30 and 60 minutes after the first nebulization, and after 60 minutes following completion of subsequent nebulization at 6, 12, 24 and 36 hours. We did not find any significant difference in the rate of improvement and the final score (p = 0.49) in the four groups. The same finding was also noted in children aged more than 3 months (p = 0.35) and in those positive for RSV infection (p = 0.18). The lengths of hospitalization in the four groups were also similar (p = 0.79). It is concluded that there is no role for the nebulized bronchodilators Salbutamol and Ipratropium bromide, either as a single agent or in combination, compared with normal saline placebo in treating young children in hospital with bronchiolitis.

译文

对入院中度疾病的毛细支气管炎的幼儿进行了一项随机临床试验,以确定与常规生理盐水安慰剂相比,支气管扩张药沙丁胺醇和异丙托溴铵作为雾化溶液作为单一药物或联合给药的疗效。年龄从23天到11个月不等的89例患者根据所用药物或安慰剂被随机分为四组,分别为1组-沙丁胺醇(n = 20)。 2-溴异丙托溴铵(n = 23);第3组:沙丁胺醇和异丙托溴铵合用(n = 24);第4组-生理盐水(n = 22)。两组在年龄,性别,特应性家族史,呼吸道合胞病毒(RSV)阳性和入组评分方面相同。在入组时,第一次雾化后30和60分钟,以及随后的雾化6、12、24和36小时后60分钟后,使用入院时的喘息,回缩和呼吸频率的临床参数对他们进行评分。在四组中,改善率和最终得分(p = 0.49)均未发现任何显着差异。在3个月以上的儿童(p = 0.35)和RSV感染阳性的儿童(p = 0.18)中也发现了相同的发现。四组的住院时间也相似(p = 0.79)。结论是,与生理盐水安慰剂相比,雾化的支气管扩张剂沙丁胺醇和溴化异丙托溴铵无论是单药还是联合用药,在治疗毛细支气管炎住院的幼儿中均没有作用。

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