小剂量肾上腺素在重症支气管哮喘院前急救应用价值.docVIP

小剂量肾上腺素在重症支气管哮喘院前急救应用价值 　　[摘要] 目的 探讨小剂量肾上腺素应用于重症支气管哮喘院前急救的临床价值。 方法 选择2012年2月～2015年6月我院接收的重症支气管哮喘患者96例，按照随机分组的方式分为对照组与观察组，各48例。对照组患者院前急救应用常规的平喘治疗，甲泼尼龙琥珀酸钠40 mg静脉注射，然后索茶碱0.25 g加入到250 mL葡萄糖溶液中进行静脉滴注。观察组患者院前急救在对照组的基础上采用小剂量肾上腺素，皮下注射0.3 mg肾上腺素，症状无改善时连续注射，但少于3次。治疗结束后比较两组患者的治疗效果和不良反应发生情况。 结果 治疗后5 min、15 min和30 min观察组患者的院前急救评分与对照组比较，差异有统计学意义（P0.05）。观察组用药治疗后5 min时开始起效，对照组用药后30 min时开始起效，起效时评分与治疗前比较，差异有统计学意义（P0.05）。 结论 小剂量肾上腺素在重症支气管哮喘的院前急救中起到有效的效果，可在临床中广泛应用。 　　[关键词] 小剂量肾上腺素；重症支气管哮喘；院前急救；不良反应 　　[中图分类号] R562.2 [文献标识码] B [文章编号] 1673-9701（2016）15-0078-03 　　[Abstract] Objective To discuss the clinical value of small-dose epinephrine in pre-hospital care of severe bronchial asthma. Methods 96 patients with severe bronchial asthma treated in our hospital from February 2012 to June 2015 were selected and randomly divided into control group and observation group， each with 48 cases. Patients in the control group were given routine relieving asthma therapy as pre-hospital care， namely， methylprednisolone sodium succinate 40 mg i.v.， followed by doxofylline 0.25 g into glucose solution 250mL i.v.， while patients in the observation group were additionally given small dose of epinephrine， namely， 0.3mg of epinephrine subcutaneous injection， continued if no improvement of condition， but fewer than three times. The treatment effects and incidence rates of adverse reactions were compared between two groups after treatment. Results There were significant differences in scores between two groups at 5， 15， and 30 min after treatment （P0.05）. Treatment effect could be observed at 5 min after treatment in the observation group， while at 30 min after treatment in the control group， and the scores at effect onset showed significant differences with those before treatment（P0.05）. Conclusion Small-dose epinephrine has favorable effect in pre-hospital care of severe bronchial asthma， which can be widely promoted in clinical practice. 　　[Key words] Small-dose epinephrine； Severe bronchial asthma； P