RU2097062C1 - Method of treatment of an acute stenosed laryngotracheitis in children - Google Patents

Abstract

FIELD: medicine, pediatry. SUBSTANCE: method involves administration of recombinant interferon in the form of aerosol depending on body mass and age. Method can be used for treatment acute respiratory viral infections passing with an acute stenosed laryngotracheitis. EFFECT: enhanced effectiveness of treatment, decreased treatment time and by-side responses.

Description

 The invention relates to medicine, namely to pediatrics and can be used in the treatment of children with acute stenosing laryngotracheitis (OSLT).

 Known methods of treating OSLT using paraoxygen medicament aerosol inhalation, laser therapy, blood AUFO (Boytsov V.P. et al. 1991; Novikova G.G. et al. 1992; Gumyarov G.K. et al. 1992 and others).

 Close to the proposed method is a comprehensive treatment of OSLT at its various stages, including bronchodilators, hormones, antibiotics, and membrane-protective preparations (Chashik S.G. et al. 1987; Borisova O.G. et al. 1991 and others).

 A significant drawback of the method lies in the fact that it is based only on symptomatic therapy aimed at individual links of the pathogenesis of the disease, while the viral nature of the main etiological factor of OSLT is not taken into account. Despite the fact that, according to the literature, various respiratory viruses are an environmental factor in OSLT in 70-80% of cases, in the complex therapy of this method there are no drugs that directly affect the pathogen. The disadvantages of the method include adverse reactions of the patient's allergic, diabetic and immunosuppressive nature, often arising during treatment.

 The purpose of the invention is to increase efficiency and reduce the treatment time for patients with OSLT while reducing the number of adverse reactions.

 This goal is achieved by the fact that for the treatment of patients with OSLT use genetically engineered interferons with antiviral and immunomodulating properties, in combination with alpha-tocopherol and ascorbic acid, which potentiate their action.

 The significance of the differences from the prototype lies in the fact that for the first time antiviral drugs are used to treat OSLT that directly affect the etiological factor and the immunocompetent system.

 The treatment method is as follows. When a patient enters the hospital, a drinking regimen (warm alkaline drink, mineral water), inhalation with mucolytics (2% sodium bicarbonate solution) four times a day are prescribed, cough syrup, antihistamines and bronchodilators are prescribed. Inhalations with realdiron are carried out twice a day (after 12 hours) at 100 thousand IU / kg of body weight for children of the first year of life and 50 thousand IU / kg of weight for children over one year of age. The course of treatment is 3 days. One ampoule of realdiron contains 1 ml. ME The contents of the ampoule are diluted in 4 ml of distilled water, then the necessary dose for a particular patient is calculated, diluted with distilled water to 30 ml per inhalation. A chest massage and thermal procedures (ozokerite, UHF on the larynx) are performed.

 Antibiotics are prescribed only upon admission to the hospital in the later stages of the disease (on the third day and later).

 Clinical examples.

 Example 1. Child K.H. 3 years, medical history N 283, 1992 was in the 16th department with a diagnosis of acute respiratory viral infections, stenosing laryngotracheitis, stenosis of the larynx of the II degree. He got acute 14 / X, a temperature of 38.8, a runny nose, a slight cough, sore throat, vomiting once. Treated with home remedies.

 The child was hospitalized for 3 days of illness. On admission, lethargy, pallor of the skin, a rough cough, hoarseness, noisy breathing at rest (inspiratory dyspnea 34 in 1 min retraction of compliant places: in the jugular fossa, intercostal space, supraclavicular region. Pharynx was hyperemic, granularity of the posterior pharyngeal wall. lungs listened to hard breathing, wheezing, heart sounds rhythmic, moderate tachycardia, pulse 120 min.

 Preliminary diagnosis: acute respiratory viral infection, acute stenosing laryngotracheitis, stenosis of the larynx of the II degree. Penicillin was prescribed (taking into account the late stages of the disease and before receiving a clinical blood test), it was canceled on the second day, antihistamines (tavegil) inside, inhalation with a 2% soda solution, cough syrup, aminophylline orally, ozokerite on the larynx, chest massage. From the first hours of admission to the hospital, inhalations with realdiron were carried out after 12 hours at doses of 50 thousand IU / kg body weight, while receiving oral administration of alpha-tocopherol and ascorbic acid.

 The condition improved after 24 hours from the start of treatment. The temperature returned to normal, the effects of intoxication, retraction of compliant places, shortness of breath disappeared. The cough became wet. Laryngeal stenosis syndrome completely stopped by the end of the second day from the start of treatment. The child was discharged home on the fifth day of hospital stay in satisfactory condition.

Example 2. Child R. M. 2 g 9 months. medical history N 908, was in the department with a diagnosis of ARVI, acute stenosing laryngotracheitis, stenosis of the larynx of the II degree. He fell ill acutely, the temperature rose to 39 ^o , a cough appeared, a slight runny nose. At night, the condition worsened, a dry coughing bark, a hoarse voice, inspiratory dyspnea, shortness of breath. Upon admission to the hospital, the condition was regarded as severe, a dry, rough cough bothered, severe shortness of breath up to 38 per minute, noisy breathing remained at rest, the skin was pale, cyanosis of the nasolabial triangle, retraction of compliant places was noted. The mucous pharynx is hyperemic, the posterior wall of the pharynx is granular. Hard breathing and dry rales were heard in the lungs. Heart sounds were muffled, the pulse corresponded to temperature. The treatment included: intramuscular cloforan, hydrocortisone, infusion therapy twice, inhalation with colitis, antihistamines and aminophylline were administered transversely.

 The improvement came at the end of the second day from the start of treatment. The temperature returned to normal on the third day, intoxication symptoms disappeared after two days, shortness of breath, retraction of compliant places were eliminated on the third day. Croup syndrome was completely stopped only on the fourth day from the start of treatment. The child was discharged home on the 7th day of hospital stay.

 The effectiveness of realdiron was evaluated by the following parameters: the state of severity of the child, the timing of the elimination of intoxication, shortness of breath, normalization of temperature, relief of laryngeal stenosis syndrome (croup syndrome).

 In children receiving realdiron, on average, intoxication disappeared after 1.9 days, the temperature returned to normal after 2.2 days, laryngeal stenosis syndrome was eliminated after 1.8 days, which is significantly shorter than in the control group (3.0 days, 3 , 6 days, 2.3 days respectively). The terms of treatment of patients decreased by 2.5 days.

The advantages of the proposed method:
pronounced positive clinical effect, providing a reduction in treatment time by 2.5 days;
in a significant percentage of cases (up to 70%), it is possible to completely exclude antibiotics and hormones from the complex of symptomatic therapy, and to avoid adverse reactions associated with their use.

Claims (1)

 A method for the treatment of acute stenosing laryngotracheitis in children, including inhalation of aerosols of drugs, characterized in that realdirone is inhaled 2 times a day for 100 thousand IU / kg of body weight for children of the first year of life and 50 thousand IU / kg of body weight for children over one year old while alpha-tocopherol and ascorbic acid are further added.