Hiệu quả của khí dung nước muối ưu trương (3%) trong điều trị viêm tiểu phế quản trẻ em tại Bệnh viện Sản nhi Bắc Giang

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Tác giả: Thị Xuyên Bàn, Thị Huệ Đoàn, Bích Hoàng Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại: 616.23 *Diseases of trachea and bronchi

Thông tin xuất bản: Khoa học và Công nghệ - Đại học Thái Nguyên, 2018

Mô tả vật lý: 19-23

Bộ sưu tập: Metadata

ID: 492302

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Bronchiolitis is one of the most common and costly respiratory diseases in infants and young children. Previous studies have shown a potential benefit of nebulized hypertonic saline (HS). Objective: To compare the effect of nebulized 3% hypertonic saline vs 0.9% normal saline on admission in infants with bronchiolitis. Method: Conducted a double-blind, randomized clinical trial bronchiolitis from March to September 2017. Recruited a convenience sample of patients 2 months - 24 months with a primary diagnosis of viral bronchiolitis presenting. We excluded patients who had chronic pulmonary disease, immune deficiency, cardiac disease, or previous episodes of wheezing or inhaled bronchodilator use. Patients received 4 ml of 3% sodium chloride or 0.9% sodium chloride (Normal sodium NS) inhaled. Results: A total of 46 patients were enrolled in the HS 3% group and 50 in the NS 0,9% group. On an intention-to-treat basis, the infants in the HS 3% group had a significant reduction (3.68 ± 1.32) in the mean clinical severity score compared to those in the NS group (2.19 ± 1.21)
[p <
0.05
CI: 0.77-1.83]. RR, SpO2 in the HS 3% group had a reduction in the mean score compared to those in the NS group. The treatment was well tolerated, with no adverse effects. Conclusion: Nebulized 3% HS is effective, safe and superior to normal saline for infants with bronchiolitis.Viêm tiểu phế quản là một trong những bệnh hô hấp phổ biến nhất ở trẻ nhũ nhi và trẻ nhỏ. Đã có nhiều nghiên cứu cho thấy một lợi ích tiềm năng của khí dung nước muối ưu trương. Tuy nhiên, chưa được áp dụng nhiều ở Bệnh viện Sản - Nhi Bắc Giang. Nghiên cứu này nhằm mục tiêu: Đánh giá hiệu quả của khí dung muối ưu trương 3% so với muối đẳng trương 0,9% ở bệnh nhi mắc viêm tiểu phế quản. Phương pháp và đối tượng nghiên cứu: Thử nghiệm lâm sàng ngẫu nhiên, trẻ từ 2 tháng đến dưới 24 tháng tuổi mắc viêm tiểu phế quản, nhập viện từ tháng 3 đến tháng 9 năm 2017, tại khoa Nhi Tổng hợp, Bệnh viện Sản - Nhi Bắc Giang. Loại trừ trẻ bệnh phổi mạn tính, thiếu miễn dịch, bệnh tim, các đợt khò khè hoặc đã sử dụng thuốc giãn phế quản trước đó. Bệnh nhi được khí dung muối ưu trương 3% (Nhóm HS hypertonic saline) hoặc muối 0,9% (Nhóm NS Normal sodium). Kết quả: Có 46 bệnh nhi nhóm HS và 50 nhóm NS. Các đặc điểm khi nhập viện về tuổi, giới tính, thời gian mắc bệnh, tần số thở, nhịp tim, SpO2, bú mẹ và tiền sử dị ứng đều tương đương nhau ở cả hai nhóm. Kết quả sau khí dung 24 giờ, cho thấy có sự cải thiện rõ rệt về điểm số lâm sàng (theo thang điểm CS Clinical Severity scores của Arch Dis Child) ở nhóm HS (3%) là 3,68 ± 1,32
nhịp thở trung bình 40,7 ± 1,9
nhịp tim trung bình 112,3 ± 6,8 và SpO2 97,9 ± 1,1 so với nhóm NS (0,9%): CS 2,19 ± 1,21
nhịp thở 44,1 ± 2,3
nhịp tim 133,1 ± 7,4 và SpO2 95,5 ±1,0. Kết luận: Khí dung nước muối ưu trương 3% có hiệu quả, an toàn và vượt trội so với muối thông thường về giảm các biểu hiện lâm sàng trên bệnh nhi mắc viêm tiểu phế quản vừa và nhẹ.

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