中国实用儿科杂志

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重症毛细支气管炎的治疗

  

  1. 重庆医科大学附属儿童医院呼吸中心,重庆  400014
  • 发布日期:2019-10-13

Treatment for severe bronchiolitis

  1. Respiratory Center,Children’s Hospital of Chongqing Medical University,Chongqing  400014,China
  • Published:2019-10-13

摘要:

毛细支气管炎主要发生于2岁以下婴幼儿,主要由呼吸道病毒尤其是呼吸道合胞病毒感染所致。临床上有自限性,其治疗以对症及支持治疗为主,包括监测病情变化、供氧以及保持水电解质内环境稳定。重症感染患儿在常规吸氧、吸痰及雾化等处理无缓解时,需采取其他措施积极治疗。包括给予肾上腺素、糖皮质激素、高渗盐水雾化吸入及积极抗感染治疗,重症毛细支气管炎患儿无创通气的应用越来越受到重视,早期使用持续气道正压通气可降低有创气管插管率,有效改善呼吸窘迫,减少呼吸做功,缩短住院时间。对具有危险因素的患儿,要密切监测病情变化,并及时处理病情的加重和恶化。

关键词: 毛细支气管炎, 重症, 治疗, 儿童

Abstract:

Bronchiolitis mainly occurs in infants under 2 years old. The infection is mainly caused by respiratory syncytial virus. Bronchiolitis  is self-limited in clinic. The treatment is mainly symptomatic and supportive treatment,including monitoring the change of disease,oxygen supply and maintaining the stability of water and electrolyte environment. Other measures should be taken to treat children with severe infection when routine oxygen inhalation,sputum aspiration and atomization are not effective. Including giving epinephrine,glucocorticoid,hypertonic saline atomization inhalation and active anti-infection treatment. More and more attention has been paid to the application of noninvasive ventilation in children with severe bronchiolitis,and early use of continuous positive airway pressure ventilation can reduce the rate of invasive tracheal intubation,effectively improve respiratory distress,reduce respiratory work and shorten hospitalization time. For children with risk factors,the changes of children’s condition should be closely monitored,and the aggravation and deterioration of the disease should be dealt with in time.

Key words: bronchiolitis, severe case, treatment, child