| Objective To analyze and summarize the clinical characteristics,treatment methods and prognosis of severe asthma in children.Methods200cases of hospitalization children with severe asthmaduring Jan.2005to Jun.2013were studied retrospectively, including theepidemiological characteristics, clinical manifestations, auxiliaryexaminations, treatments and outcomes.Results (1) Epidemiological characteristics：The gender ratio of thepatients is1.44(male):1(female).It is relatively high in morbidity of boys.The age of onset is relatively higher in children between3to5years old,accounting for54%. Season of onset is relatively higher in winter,accounting for37.5%. Respiratory infection is the most common cause ofsevere asthma, which is accounting for67.5%.(2) After a series ofcomprehensive treatments including a general symptomatic treatment,β2receptor agonist and glucocorticoid, symptoms in children wereobviously relieved.(3) In200cases of children with severe asthma, only one child died because of respiratory failure, due to delayed treatment.Two left hospital automatically. The left197children (accounting for98.5%) were improved and discharged. The days of hospitalization were10.4±2.1days and the days of improved were2.8±1.2days.Conclusion (1)The morbidity of boys is relatively high in severeasthma. The age of onset is more general between3to5years old. Theincidence of asthma is higher in winter than in other seasons. Theinfection of respiratory tract is the key causative factor.(2) The keys toimprove the success rate of treatment in severe asthma include thefollowing points, early diagnosis, relieving asthma rapidly, proper usingof drugs, and eliminating the causes positively. Keeping respiratory tractunobstructed and maintaining the balance of internal environment arebasic guarantees of treatment. Meanwhile, the complications should betreated early.(3) β2receptor agonist and glucocorticoid are first choicesin asthma treatment. Therefore, the intravenous glucocoriticoid shouldbe used as soon as possible. For the combined infection, it is necessary touse the effective antibiotics timely depending on drug susceptibility,which could accelerate the recovery of the patients.(4) There is along-term process for treating asthma. Regular follow-up is necessaryduring their remission period. Education to parents and their children arehelpful. The purpose is to reduce asthma attacks. Objective To discuss the efficacy of intravenous immunoglobulin intreatment of children with severe asthma.Methods41cases of patients with severe asthma were divided intotreatment group (n=20) and control group (n=21). The two groups bothaccepted integrated treatments. In the treatment group, intravenousimmunoglobulin was administrated, with the dose of1g/kg·d for two day.After the above treatments, the duration of cough, shortness of breath andwheeze, the length of stay, the change of blood gas analysis wereobserved and compared.Results The hospitalization days and remission time of cough,shortness of breath and wheeze were all shorter in the treatment groupthan in the control group（P<0.05，P<0.01）. The blood gas analysisindexes in the treatment group were superior to those in the control group（P<0.01， P<0.05）. No considerable side effect was found. Conclusions For the children with severe asthma, besides thetreatments by oxygen inhalation, keeping respiratory tract unobstructed,keeping water-electrolyte and acid-base balance via fluid infusion,inhalation of β2receptor agonist, intravenous glucocorticoid andanti-infective therapy, the use of intravenous immunoglobulin can shortenthe remission time of symptoms and the course of disease. Since thecurative effect is specific, intravenous immunoglobulin can be used as aneffective measure in treatment of severe asthma. |
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