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雾化吸入3%高渗盐水联合沙丁胺醇对门诊成年急性哮喘患者治疗的影响:急诊科双盲随机临床试验

Effect of Nebulized 3% Hypertonic Saline with Salbutamol on Management of Acute Asthma in Outpatient Adults: A Double-blind, Randomized Clinical Trial in Emergency Department.

作者信息

Forouzan Arash, Masoumi Kambiz, Delirrooyfard Ali, Asgari Darian Ali, Mokhtar Gandomani Laaya

机构信息

Department of Emergency Medicine, Imam Khomeini General Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

Iran J Allergy Asthma Immunol. 2017 Oct;16(5):370-377.

Abstract

Asthma is one of the most common disorders of respiratory tract, management of which still remains as a serious health problem. This study aimed to compare the efficacy of 3% hypertonic saline (HS) plus salbutamol with solely salbutamol on management of acute adults' asthma based on peak flow meter findings. In this double-blind randomized clinical trial, 340 adult patients with acute asthma attacks admitted to emergency department of Ahvaz Golestan and Emam hospitals were enrolled during 2014-2015. The patients were allocated randomly to intervention group (nebulized 2.5 mg of salbutamol and 2.5 mL of 3% HS solution for three consecutive 20-min periods) and control group (nebulized only salbutamol in the same dose and time of the intervention group). The principal outcome measures were forced expiratory volume in 1 second (FEV1) and peak expiratory flow rate (PEFR), which were assessed at baseline, and 20, 40 and 60 minutes after treatment in both groups. HS plus salbutamol resulted in a significant increase compared with solely salbutamol in both PEFR and FEV1 in 40th min (0.11±1.36; p=0.036 and 0.05±1.16; p=0.033, respectively) and 60th min (0.15±1.12; p<0.001 and 0.11±1.22; p=0.011, respectively), while no significant difference was observed in baseline and 20th min. Also, PEFR and FEV1 in both groups significantly increased as the treatment processed and the time passed. The results showed the beneficial effects of 3% HS in management of adults with acute asthma in the short term.

摘要

哮喘是最常见的呼吸道疾病之一,其治疗仍是一个严重的健康问题。本研究旨在根据峰值流量计的结果,比较3%高渗盐水(HS)联合沙丁胺醇与单纯使用沙丁胺醇治疗成人急性哮喘的疗效。在这项双盲随机临床试验中,2014年至2015年期间,招募了340名因急性哮喘发作而入住阿瓦士戈勒斯坦医院和伊玛目医院急诊科的成年患者。患者被随机分配到干预组(连续三个20分钟时段雾化吸入2.5毫克沙丁胺醇和2.5毫升3% HS溶液)和对照组(在与干预组相同的剂量和时间仅雾化吸入沙丁胺醇)。主要观察指标为第1秒用力呼气量(FEV1)和呼气峰值流速(PEFR),在两组的基线、治疗后20、40和60分钟进行评估。在第40分钟(分别为0.11±1.36;p=0.036和0.05±1.16;p=0.033)和第60分钟(分别为0.15±1.12;p<0.001和0.11±1.22;p=0.011)时,与单纯使用沙丁胺醇相比,HS联合沙丁胺醇使PEFR和FEV1均显著增加,而在基线和第20分钟时未观察到显著差异。此外,随着治疗的进行和时间的推移,两组的PEFR和FEV1均显著增加。结果表明,3% HS在短期内对成人急性哮喘的治疗具有有益作用。

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