摘要
目的探讨小剂量地塞米松治疗新生儿细菌性脑膜炎疗效及安全性分析。方法选择2016年11月-2020年11月在本院住院并诊断为新生儿细菌性脑膜炎的足月儿92例,在抗生素治疗的基础上,随机分为地塞米松组和对照组,比较两组患儿的临床疗效(治疗疗程、退热天数、治疗24h及疗程结束时脑脊液常规及生化的改变)及相关安全性指标(二次发热、胃肠道出血的发生率)。结果两组患儿的治疗疗程比较无统计学差异,地塞米松组的退热天数小于对照组,差异有统计学意义;两组患儿入组时、治疗24h及疗程结束时脑脊液白细胞、蛋白和葡萄糖比较均无统计学差异;两组患儿的病死率、二次发热及胃肠道出血发生率比较无统计学差异,地塞米松组听力受损的发生率低于对照组,差异有统计学意义。结论地塞米松早期小剂量联合抗生素治疗可以缩短热退时间、减少出院前听力受损的发生率,并且无二次发热、消化道出血常见不良反应,但对患儿病死率、治疗疗程并无明显影响。
Objective To investigate the efficacy and safety of low-dose dexamethasone in the treatment of neonatal bacterial meningitis.Methods 92 term infants,diagnosed with bacterial meningitis from November 2016 to November 2020 in our hospital,were randomly divided into dexamethasone group and control group on the basis of antibiotic treatment.Then the clinical efficacy(treatment course,antifebrile days,the biochemical changes of cerebrospinal fluid at the treatment time of 24h and the end of course)and related safety index(secondary heating,the incidence of gastrointestinal bleeding).Results There was no statistically difference between the two groups in the course of treatment.Dexamethasone group had fewer antifebrile days than the control group,and the difference was statistically significant.There were no statistically significant differences in white blood cells,protein and glucose in CSF between the two groups at enrollment,24 hours of treatment and the end of treatment.There were no statistically significant differences in mortality,secondary fever and gastrointestinal bleeding between the two groups.The incidence of hearing impairment in the dexamethasone group was lower than that in the control group,and the difference was statistically significant.Conclusion Early low-dose of dexamethasone combined with antibiotics can shorten the time of fever regression and reduce the incidence of hearing loss before discharge,and there is no secondary fever or common adverse reactions of gastrointestinal bleeding,but it has no significant influence on the mortality and treatment course of infants.
作者
曾国志
吕临静
谭普浩
ZENG Guozhi;LV Linjing;TAN Puhao(Pediatrics of Huizhou First Hospital,Huizhou,Guangdong,516100,China)
出处
《新疆医学》
2023年第3期328-330,368,共4页
Xinjiang Medical Journal
关键词
地塞米松
细菌性脑膜炎
疗效
Dexamethasone
Bacterial meningitis
Efficacy
