Pitluk Jessica Danielle, Uman Howard, Safranek Sarah
Swedish Family Medicine Residency-First Hill, Seattle, WA, USA.
J Fam Pract. 2011 Nov;60(11):680-1.
A single dose of corticosteroids is the first-line treatment for croup, resulting in fewer return visits and hospital admissions, shorter lengths of stay in the emergency department (ED) or hospital, and less need for supplemental medication (strength of recommendation [SOR]: A, meta-analysis and randomized controlled trials [RCTs]). A 0.15 mg/kg dose of oral dexamethasone is as effective as larger doses (SOR: B, small RCTs).Nebulized racemic or L-epinephrine reduces severity of symptoms in moderate-to-severe croup (SOR: C, limited-quality disease-oriented evidence).The role of heliox in moderate to severe croup remains uncertain. Studies to date have been inadequate (SOR: C, limited-quality disease-oriented evidence).Humidified air provides no demonstrable benefit in the acute setting (SOR: A, meta-analysis).
单次剂量的皮质类固醇是治疗哮吼的一线疗法，可减少复诊次数和住院人数，缩短在急诊科（ED）或医院的住院时间，并减少补充用药的需求（推荐强度[SOR]：A，荟萃分析和随机对照试验[RCT]）。0.15 mg/kg剂量的口服地塞米松与较大剂量同样有效（SOR：B，小型RCT）。雾化消旋肾上腺素或L-肾上腺素可减轻中重度哮吼的症状严重程度（SOR：C，低质量的以疾病为导向的证据）。氦氧混合气在中重度哮吼中的作用仍不确定。迄今为止的研究尚不充分（SOR：C，低质量的以疾病为导向的证据）。在急性发作期，湿化空气并无明显益处（SOR：A，荟萃分析）。
