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目的比较两种不同用法的丙种球蛋白对小儿重症手足口病合并脑炎的疗效。方法选取92例重症手足口病合并脑炎患儿的临床资料,根据治疗情况分为:A组为入院前未应用丙种球蛋白患儿,B组为入院前曾在外院按400mg/(kg·d)已经开始应用丙种球蛋白患儿,分成A、B两组,A组48例,B组44例。A组:入院后静脉滴注丙种球蛋白1g/(kg·d)每日1次,连用2天,B组:入院前曾静脉滴注丙种球蛋白按400mg/(kg·d)每日1次,入院后继续静脉滴注按丙种球蛋白400mg/(kg·d)每日1次,包含入院前共连用5天。两组患儿在两种不同用法的丙种球蛋白静脉滴注的基础上,加用甲基泼尼松龙2mg/(kg·d)静脉滴注等常规治疗。结果 A组持续发热时间、持续机械通气时间、惊跳缓解时间、高血压的持续时间及病程明显短于B组,P<0.05,差异具有统计学意义。结论按1g/(kg·d)大剂量应用丙种球蛋白连用2天治疗小儿重症手足口病合并脑炎可缩短病症改善时间及病程,改善预后,疗效显著,在临床中可以积极应用。
Objective To compare the curative effects of two different uses of gamma globulin on children with severe HFMD complicated with encephalitis. Methods The clinical data of 92 severe HFMD patients with encephalitis were selected according to the treatment conditions: group A was not treated with gamma globulin prior to admission; group B was treated with 400 mg / (kg · d) Children with gamma globulin have begun to be divided into A and B groups, 48 in group A and 44 in group B. Group A: intravenous infusion of IgM 1 g / (kg · d) once daily for 2 days after admission; Group B: intravenous gamma globulin 400 mg / (kg · d) daily before admission Times, continue to intravenous infusion of gamma globulin 400mg / (kg · d) once a day, including a total of 5 days before admission. Two groups of children in two different uses of gamma globulin intravenous infusion plus methylprednisolone 2mg / (kg · d) intravenous drip and other conventional treatment. Results Duration of persistent fever, duration of mechanical ventilation, duration of shock relief, duration of hypertension and duration of disease in group A were significantly shorter than those in group B (P <0.05). The difference was statistically significant. Conclusions The application of gamma globulin at a dose of 1 g / (kg · d) for two days in children with severe HFMD complicated with encephalitis can shorten the time and course of disease improvement, improve the prognosis and have a significant therapeutic effect. Therefore, it can be actively used clinically.