Kunitoh H
Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1994 Dec;32 Suppl:50-6.
Many problems remain to the solved in the management of acute bronchial asthma. Acute fatal or near-fatal asthma can occur in apparently low-risk patients. Patients should be educated about the potential risk of the disease. Subjective degree of dyspnea perceived by the patients was useful in judging the severity of the attack and in predicting the outcome, i.e. need for hospitalization after the initial treatment. However, clinical status on arrival at the emergency room did not predict the out-come. In the treatment of acute attacks, the optimal dosage and timing of corticosteroids and the effectiveness of aminophylline remain controversial. Many patients with respiratory failure due to acute severe asthma can be successfully treated without mechanical ventilation. There have been very few clinical studies of acute asthma in Japan. Appropriately planned and performed clinical studies are clearly necessary to solve the problems encountered in the management of acute asthma, and such studies should be done in Japan.
在急性支气管哮喘的管理方面仍有许多问题有待解决。急性致命性或近乎致命性哮喘可能发生在看似低风险的患者中。应该让患者了解该疾病的潜在风险。患者感知到的主观呼吸困难程度有助于判断发作的严重程度和预测结果，即初始治疗后是否需要住院。然而，到达急诊室时的临床状况并不能预测结果。在急性发作的治疗中，皮质类固醇的最佳剂量和给药时间以及氨茶碱的有效性仍存在争议。许多因急性重症哮喘导致呼吸衰竭的患者无需机械通气即可成功治疗。在日本，急性哮喘的临床研究很少。显然，需要进行适当规划和开展的临床研究来解决急性哮喘管理中遇到的问题，而且此类研究应该在日本进行。
