一项评估大容量储雾罐和雾化器在医院治疗急性哮喘相对益处的随机对照试验。
A randomised controlled trial to assess the relative benefits of large volume spacers and nebulisers to treat acute asthma in hospital.
作者信息
Dewar A L, Stewart A, Cogswell J J, Connett G J
机构信息
Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.
出版信息
Arch Dis Child. 1999 May;80(5):421-3. doi: 10.1136/adc.80.5.421.
OBJECTIVES
To compare the clinical effectiveness, acceptability, and cost benefit of administering beta2 agonists by means of a metered dose inhaler and large volume spacer with conventional nebulisers to children admitted to hospital with acute asthma.
METHODS
A randomised controlled trial was conducted over five months. Sixty one children older than 3 years admitted to a large teaching hospital and a district general hospital with acute asthma completed the study. Children received either 5 mg of salbutamol up to one hourly by jet nebuliser, or up to 10 puffs of salbutamol 100 microg by means of a metered dose inhaler and spacer up to one hourly.
RESULTS
Median hospital stay was 40 hours in the nebuliser group and 36.5 hours in the spacer group. Asthma disability scores at two weeks after discharge were significantly improved in the spacer group. Drug costs were pound 14.62 less for each patient in the spacer group.
CONCLUSIONS
Large volume spacers are an acceptable, cost effective alternative to nebulisers in treating children admitted with acute asthma, provided that the children can use the mouthpiece, and symptoms are not severe. Their use facilitates effective home treatment by parents, with subsequent reduction in morbidity and re-admission rates.
目的
比较对于因急性哮喘入院的儿童，使用定量吸入器和大容量储雾罐与传统雾化器给予β2激动剂的临床疗效、可接受性和成本效益。
方法
进行了一项为期五个月的随机对照试验。61名3岁以上因急性哮喘入住一家大型教学医院和一家地区综合医院的儿童完成了该研究。儿童通过喷射雾化器每小时接受5毫克沙丁胺醇，或通过定量吸入器和储雾罐每小时接受多达10喷100微克的沙丁胺醇。
结果
雾化器组的中位住院时间为40小时，储雾罐组为36.5小时。出院两周后的哮喘残疾评分在储雾罐组有显著改善。储雾罐组每位患者的药物成本比雾化器组少14.62英镑。
结论
对于因急性哮喘入院的儿童，大容量储雾罐是雾化器的一种可接受、具有成本效益的替代方法，前提是儿童能够使用吸嘴且症状不严重。其使用便于家长进行有效的家庭治疗，进而降低发病率和再入院率。
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