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      中國文獻查重檢測系統

      多語種 圖文 指定高校抄襲檢測系統

      Vit K1治療痙攣性咳嗽臨床分析

      2019-05-14  分類:常規論文查重  閱讀(56)

      以下內容由知網查重網站收集整理!知網查重提醒大家,畢業論文是考驗大家大學四年的成果,應當認真應對!切勿剽竊他人的學術成果。專科本科重復率30以上將不能順利畢業延遲答辯!碩士及以上學歷重復率不能超出百分之20,個別學校需要百分之十以下!

      摘 要:目的:探討Vit K1治療小兒痙攣性咳嗽的臨床療效及安全性。方法:對128例痙攣性咳嗽患兒使用Vit K1治療,觀察其治療效果與藥物不良反應。結果:128例痙攣性咳嗽患兒經Vit K1治療后,3~5 d咳嗽癥狀消失者119例,占92.97%;5 d以上咳嗽癥狀消失者4例,占3.13%,治療效果顯著。所有患者未出現明顯不良反應。結論:使用Vit K1肌內注射治療小兒痙攣性咳嗽療效顯著,無明顯不良反應,具有重要的臨床應用價值。

      關鍵詞:Vit K1;痙攣性咳嗽;效果

      小兒支氣管炎、支氣管肺炎或上呼吸道感染常可引起患兒痙攣性咳嗽。若病情未能及時控制,易使小兒引起心力衰竭、呼吸衰竭等嚴重后果。廣東省廣州市越秀區兒童醫院對2009年1月~2011年5月收治的128例痙攣性咳嗽患兒在使用抗生素抗病毒及解痙藥物治療無效時,使用Vit K1治療,取得良好的治療效果,現將結果報告如下。

      1 資料與方法

      1.1一般資料:選取我院2009年1月~2011年5月收治的128例痙攣性咳嗽患兒,其中男73例,女55例,年齡3個月~8歲。128例患兒中,肺炎63例,支氣管炎33例,毛細支氣管炎27例,上呼吸道感染5例。患兒臨床表現均有痙攣性咳嗽,伴氣喘、呼吸急速、肺部出現干濕啰音,每次咳嗽持續3 min以上,每天發作10余次。X線檢查可見患兒肺部有斑片狀陰影。

      1.2治療方法:采用Vit K1肌內注射給藥方式;全日咳嗽患兒每天早晚各一次,夜間或晨起咳嗽患兒于夜間或晨起肌內注射一次。劑量:小于l歲患兒每次給予Vit K1 5 mg,1~2次/d;大于l歲患兒每次給予10 mg,1~2次/d;對于咳嗽嚴重的患兒酌情增加藥物劑量,一般療程為3~7 d。

      1.3療效評價:顯效:用藥3 d后患兒咳嗽癥狀明顯改善,肺部啰音消失;有效:用藥5 d后患兒咳嗽癥狀改善,肺部啰音基本消失;無效:用藥5 d后患兒咳嗽癥狀無明顯改善,肺部啰音未消失。

      2 結果

      128例痙攣性咳嗽患兒在肌內注射Vit K1半小時后可見咳嗽癥狀緩解,藥物持續作用時間約為8~12 h。治療3 d,咳嗽癥狀消失者37例(28.91%);治療4 d,咳嗽癥狀消失者59例(46.09%);治療5 d,咳嗽癥狀消失者23例(17.97%)。3~5 d咳嗽癥狀消失者共計119例,占92.97%;5 d以上咳嗽癥狀消失者4例,占3.13%,治療效果顯著。觀察患兒肌內注射Vit K1后不良反應情況,所有患兒均未出現明顯不良反應。

      3 討論

      咳嗽屬人體的一種保護性反射,是小兒呼吸系統疾病中的常見癥狀[1]。當小兒呼吸道存在炎性反應時,可刺激迷走神經、舌咽神經將沖動信號傳入咳嗽中樞,后經由喉下神經、膈神經、脊神經將沖動傳出,引發咳嗽。正常生理情況下,咳嗽能清除呼吸道異物或炎性滲出物,對呼吸道具有保護作用。但在病理情況下,持續劇烈的咳嗽將嚴重影響患兒的睡眠與健康。臨床上,患有支氣管炎、支氣管肺炎、呼吸道感染的患兒嚴重時可引起痙攣性咳嗽。由于患兒口服藥物治療效果差,本文對128例痙攣性咳嗽患兒在使用抗生素抗病毒及解痙藥物治療無效時,使用Vit K1治療,療效滿意。

      Vit K1化學結構為甲萘醌,是一種脂溶性維生素,由于其參與了肝臟凝血因子Ⅱ、Ⅵ、Ⅸ、Ⅹ的合成,常被臨床用于止血。近年來,臨床研究發現Vit K1可直接作用于人體平滑肌,使痙攣的平滑肌松弛,解除平滑肌痙攣引起的疼痛,可用于治療膽道蛔蟲癥、腸道蛔蟲梗阻等。目前,Vit K1用于治療痙攣性咳嗽,其主要原理是對支氣管平滑肌發揮解痙作用。受體學說認為支氣管平滑肌痙攣與β-受體阻滯相關。生理狀況下,人體平滑肌細胞膜上的β-受體腺苷酸環化酶在Mg2+、Ca2+存在時可將細胞內ATP轉化cAMP,對組胺、緩激肽及慢反應物質起到有效抑制的作用,進而舒張支氣管平滑肌,使呼吸道保持通暢。多項研究顯示,Vit K1可以促使細胞內cAMP的合成,使cAMP/cGMP比值升高;在肝臟內延緩腎上腺皮質激素的分解;并且可以鎮靜、鎮痛,有效抑制咳嗽中樞。目前,國內已逐漸有使用Vit K1治療小兒毛細支氣管炎,重癥支氣管肺炎的相關報道[2-3]。

      本文對我院128例痙攣性咳嗽患兒采用肌內注射Vit K1治療,結果顯示肌內注射半小時后可見患兒咳嗽癥狀緩解,治療3~5 d咳嗽癥狀消失者共119例,占92.97%;5 d以上咳嗽癥狀消失者4例,占3.13%,治療效果顯著。此外,觀察患兒肌內注射Vit K1后不良反應情況,所有患兒均未出現明顯不良。

      由此可見,使用Vit K1治療小兒痙攣性咳嗽具有止咳作用快,效果顯著的優點。尤其是對于有氣喘癥狀的患兒,解痙止咳效果更明顯。所有患兒在使用Vit K1肌內注射后陣發性痙攣性咳嗽程度減輕,咳嗽頻率減少,患兒的精神狀態及食欲明顯。此外,肌內注射Vit K1未見明顯不良反應,對治療小兒痙攣性咳嗽具有重要的臨床應用價值。

      4 參考文獻

      [1] 黃素霞.聯用Vit K1治療小兒喘息性疾病40例療效觀察[J].中原醫刊,2005,10(1):51.

      [2] 何學坤,何蓮.酚妥拉明和Vit K1治療小兒毛細支氣管炎療效觀察[J].右江醫學,2005,33(4):399.

      [3] 王國偉.酚妥拉明和Vit K1治療重癥支氣管肺炎140例的療效觀察[J].藥物與臨床,2010,17(6):55.

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