摘要
目的:探讨早期联合应用小剂量甲泼尼龙与甘露醇干预对防止伴发热症状的手足口病普通病例进展至重症化的临床疗效。方法:选择200例伴发热症状的手足口病普通病例,随机分为A组(治疗组)100例和B组(对照组)100例。两组均给予常规治疗,在此基础上治疗组加用20%甘露醇0.5 g/kg快速静脉滴注,每8 h 1次,甲泼尼龙2 mg/(kg.d)加入10%葡萄糖溶液50 ml静脉滴注;若无重症发生,两药联合应用3 d后停药。观察两组患者的病情进展。结果:治疗组100例患儿无一例进展至重症,均治愈;对照组有6例进展到神经系统受累期,两组进展至重症的发生率比较差异有统计学意义(P<0.05);未发生重症的两组患儿比较,治疗组在退热、口腔溃疡愈合、皮疹消退及住院时间均短于对照组(P<0.05)。结论:早期联合应用小剂量甲泼尼龙与甘露醇可干预有发热症状的手足口病普通病例病情进展、防止重症发生,明显提高手足口病的救治成功率。
Objective： To investigate the clinical effects of early combined application of small-dose methylprednisolone and mannitol on preventing hand-foot-and-mouth disease （HFMD） cases associated with fever from progressing to the phase of nervous system damage. Methods： Two hundred common HFMD cases associated with fever were randomly divided into Group A （ Treatment group, n = 100） and Group B （ control group, n = 100）. Conventional nursing care and treatment were given to the both groups. In addition, mannitol （0. 5 mg/g · kg, q8h） and methylprednisolone （2 mg/kg · d） were given to the participants in Group A for 3 days unless serious events. Results： No severe progressing was observed in Group A, while 6 system damage were observed in Group B, with significant difference betw cases progressed to the phase of nervous een the 2 groups （P 〈 0. 05 ）. In common cases without progressing to the severe phase, significantly shorter antifebrile time, oral cavity ulcer healing time, rash subsiding time, and hospital stay were recorded in the Group A （P 〈 0. 05 ）. Conclusions： Early combined application of small-dose methylprednisolone and mannitol can prevent common Hand-foot-and-mouth disease（HFMD） cases associated with fever from progressing to the severe phase and improve prognosis.
出处
《新医学》
2012年第11期791-794,共4页
Journal of New Medicine
关键词
甲泼尼龙
小剂量
甘露醇
手足口病
Methylprednisolone
Small-dose
Mannitol
Hand-foot-and-mouth disease
