Skolnik N S
Department of Family Medicine, Thomas Jefferson University, Philadelphia, Pa.
Am J Dis Child. 1989 Sep;143(9):1045-9. doi: 10.1001/archpedi.1989.02150210079022.
Although viral croup is the most common form of airway obstruction in children 6 months to 6 years of age, there is debate regarding medical care for the hospitalized patient. A complete review of the English-language literature from 1960 to 1988 was performed, using both manual and Medline searches. Critical review shows that laryngotracheitis and spasmodic croup, previously emphasized in the literature as having distinct etiologies, most likely are two ends of a broad spectrum in the clinical presentation of a single disease. Critical assessment of all prospective randomized double-blind placebo-controlled trials reported during the study period shows that there is little information on the use of humidified air or supplemental oxygen, that racemic epinephrine hydrochloride is of well-demonstrated efficacy, and that dexamethasone phosphate at a dose greater than 0.3 mg/kg is effective in decreasing the length and severity of respiratory symptoms associated with viral croup.
尽管病毒性哮吼是6个月至6岁儿童气道梗阻最常见的形式，但对于住院患者的医疗护理仍存在争议。我们使用手工检索和医学文献数据库检索的方式，对1960年至1988年的英文文献进行了全面回顾。批判性综述表明，喉气管炎和痉挛性哮吼，此前在文献中强调具有不同病因，很可能是单一疾病临床表现广泛谱中的两个端点。对研究期间报告的所有前瞻性随机双盲安慰剂对照试验的批判性评估表明，关于使用湿化空气或补充氧气的信息很少，消旋盐酸肾上腺素的疗效已得到充分证明，且剂量大于0.3mg/kg的磷酸地塞米松可有效缩短与病毒性哮吼相关的呼吸道症状的持续时间并减轻其严重程度。
