李　健辽宁省朝阳市第二医院急诊科，辽宁朝阳　122000

小剂量肾上腺素在重症支气管哮喘院前急救的应用价值

李健
辽宁省朝阳市第二医院急诊科，辽宁朝阳122000

目的探讨小剂量肾上腺素应用于重症支气管哮喘院前急救的临床价值。方法选择2012年2月～2015年6月我院接收的重症支气管哮喘患者96例，按照随机分组的方式分为对照组与观察组，各48例。对照组患者院前急救应用常规的平喘治疗，甲泼尼龙琥珀酸钠40mg静脉注射，然后索茶碱0.25 g加入到250mL葡萄糖溶液中进行静脉滴注。观察组患者院前急救在对照组的基础上采用小剂量肾上腺素，皮下注射0.3mg肾上腺素，症状无改善时连续注射，但少于3次。治疗结束后比较两组患者的治疗效果和不良反应发生情况。结果治疗后5min、15min和30min观察组患者的院前急救评分与对照组比较，差异有统计学意义（P＜0.05）。观察组用药治疗后5 min时开始起效，对照组用药后30 min时开始起效，起效时评分与治疗前比较，差异有统计学意义（P＜0.05）。结论小剂量肾上腺素在重症支气管哮喘的院前急救中起到有效的效果，可在临床中广泛应用。

小剂量肾上腺素；重症支气管哮喘；院前急救；不良反应

［Abstract］Objective To discuss the clinical value of small-dose epinephrine in pre-hospital care of severe bronchial asthma.M ethods 96 patients with severe bronchial asthma treated in our hospital from February 2012 to June 2015 were selected and randomly divided into control group and observation group，each with 48 cases.Patients in the control group were given routine relieving asthma therapy as pre-hospital care，namely，methylprednisolone sodium succinate 40mg i.v.，followed by doxofylline 0.25 g into glucose solution 250mL i.v.，while patients in the observation group were additionally given small dose of epinephrine，namely，0.3mg of epinephrine subcutaneous injection，continued if no improvement of condition，but fewer than three times.The treatment effects and incidence rates of adverse reactions were compared between two groups after treatment.Results There were significant differences in scores between two groups at 5，15，and 30min after treatment（P＜0.05）.Treatmenteffect could be observed at 5min after treatment in the observation group，while at 30min after treatment in the control group，and the scores at effect onset showed significant differenceswith those before treatment（P＜0.05）.Conclusion Small-dose epinephrine has favorable effect in pre-hospital care of severe bronchial asthma，which can be widely promoted in clinical practice.

［Key words］Small-dose epinephrine；Severe bronchial asthma；Pre-hospital care；Adverse reaction

支气管哮喘是一种慢性的气道炎性症状，表现出气道高反应性，出现可逆性的气流受限，进而致使喘息、气促和咳嗽反复的发作，严重时救治不及时可出现休克，甚至死亡［1-3］。重症支气管哮喘的发作时，入院前需要必要的急救措施，为院内的急救提供时间，也是成功抢救的关键措施。……