Jeong Hyeri, Park Dawon, Ha Eun Kyo, Kim Ju Hee, Shin Jeewon, Baek Hey-Sung, Hwang Hyunsoo, Shin Youn Ho, Jee Hye Mi, Han Man Yong
Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.
Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.
Clin Exp Pediatr. 2024 Nov;67(11):608-618. doi: 10.3345/cep.2023.01676. Epub 2024 Oct 28.
Acute bronchiolitis is a common cause of hospitalization during infancy that carries significant morbidity and mortality rates.
This study compared the efficacy of different treatment modalities for infants with bronchiolitis in terms of hospital stay and clinical severity scores.
The PubMed database was searched for relevant studies. Eligibility criteria included double-blind randomized controlled trial design, assessment of the effect of treatment on bronchiolitis in infants under 2 years of age, and publication in English from inception through July 31, 2020. The primary efficacy outcome was the length of hospital stay, while the secondary outcome was the clinical severity score. The standardized treatment effect and standard error of the effect size were calculated.
We identified 45 randomized controlled trials of 24 pairwise comparisons. These 45 trials included 5,061 participants and investigated 13 types of interventions (12 active, 1 placebo). Inhalation therapy with epinephrine (standard mean difference [SMD], -0.41; 95% confidence interval [CI], -0.8 to -0.03) and hypertonic saline (SMD, -0.29; 95% CI, -0.55 to -0.03) reduced the length of hospital stay compared with normal saline. Hypertonic saline was the most effective at improving the clinical severity score (SMD, -0.52; 95% CI, -0.95 to -0.10).
Inhalation therapy with epinephrine and hypertonic saline reduced the length of hospital stay and the clinical severity of bronchiolitis among infants under 2 years of age.
急性细支气管炎是婴儿期住院的常见原因，具有较高的发病率和死亡率。
本研究比较了不同治疗方式对细支气管炎婴儿住院时间和临床严重程度评分的疗效。
检索PubMed数据库中的相关研究。纳入标准包括双盲随机对照试验设计、评估治疗对2岁以下婴儿细支气管炎的效果以及2020年7月31日前发表的英文文献。主要疗效指标为住院时间，次要指标为临床严重程度评分。计算标准化治疗效果和效应大小的标准误差。
我们确定了45项随机对照试验，共24组两两比较。这45项试验包括5061名参与者，研究了13种干预措施（12种有效，1种安慰剂）。与生理盐水相比，肾上腺素吸入疗法（标准均差[SMD]，-0.41；95%置信区间[CI]，-0.8至-0.03）和高渗盐水吸入疗法（SMD，-0.29；95%CI，-0.55至-0.03）可缩短住院时间。高渗盐水在改善临床严重程度评分方面最有效（SMD，-0.52；95%CI，-0.95至-0.10）。
肾上腺素和高渗盐水吸入疗法可缩短2岁以下婴儿细支气管炎的住院时间并降低其临床严重程度。
