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目的:探讨注射用人免疫球蛋白治疗手足口病合并病毒性脑炎的疗效及可行性。方法:回顾性分析我院2013年1月至2016年1月收治的136例手足口病合并脑炎患儿临床资料,按照是否使用注射用免疫球蛋白治疗分为观察组72例和对照组64例。所有患儿均给予降温、抗病毒[利巴韦林10~15 mg/(kg·d)静脉滴注]、抗炎[地塞米松0.2~0.5 mg/(kg·d)]、降颅压(20%甘露醇0.25~1.00 g/kg)、加强营养支持、维持水电解质平衡、合并细菌感染者给予头孢克肟抗感染等常规治疗,观察组在常规治疗的基础上给予静脉注射人免疫球蛋白1.0 g/(kg·d),连续应用2~5 d。结果:观察组总有效率94.4%,对照组总有效率82.8%,差异有统计学意义(P<0.05)。观察组体温恢复时间、皮疹消退时间、神经系统症状消失时间和住院时间分别为(3.9±1.3)d、(4.0±1.5)d、(3.2±1.4)d和(6.8±2.0)d,短于对照组的(5.9±1.6)d、(6.8±2.5)d、(4.9±2.0)d和(11.5±3.5)d,差异有统计学意义(P<0.05)。治疗后两组患儿血清IL-6和IL-8水平显著下降(P<0.05),且观察组的下降幅度显著大于对照组,差异有统计学意义(P<0.05)。结论:静脉注射用人免疫球蛋白治疗手足口病合并病毒性脑炎疗效显著,能有效改善患儿的临床症状,促进疾病的康复。
Objective: To investigate the efficacy and feasibility of injecting human immunoglobulin in the treatment of hand, foot and mouth disease with viral encephalitis. Methods: The clinical data of 136 children with hand-foot-mouth disease complicated with encephalitis admitted in our hospital from January 2013 to January 2016 were retrospectively analyzed. According to the treatment of immunoglobulin for injection, 72 cases were divided into observation group and control group example. All patients were given cooling, anti-virus [ribavirin 10 ~ 15 mg / (kg · d) intravenous infusion], anti-inflammatory [dexamethasone 0.2 ~ 0.5 mg / (kg · d)], reducing intracranial pressure (20% mannitol 0.25 ~ 1.00 g / kg), to enhance nutritional support, to maintain water and electrolyte balance, bacterial infections were given cefixime anti-infective and other conventional treatment, the observation group on the basis of routine treatment given intravenous injection of human immunoglobulin Protein 1.0 g / (kg · d), continuous application of 2 ~ 5 d. Results: The total effective rate was 94.4% in the observation group and 82.8% in the control group, the difference was statistically significant (P <0.05). The body temperature recovery time, rash subsidence time, disappearance time of neurological symptoms and hospital stay in the observation group were (3.9 ± 1.3) d, (4.0 ± 1.5) d, (3.2 ± 1.4) d and (6.8 ± 2.0) d, respectively (5.9 ± 1.6) days, (6.8 ± 2.5) days, (4.9 ± 2.0) days and (11.5 ± 3.5) days in the control group. The difference was statistically significant (P <0.05). After treatment, the serum levels of IL-6 and IL-8 in the two groups were significantly decreased (P <0.05), and the decrease in the observation group was significantly greater than that in the control group (P <0.05). Conclusion: Intravenous injection of human immunoglobulin in the treatment of hand, foot and mouth disease with viral encephalitis has significant effect, which can effectively improve the clinical symptoms of children and promote the rehabilitation of the disease.