摘要
目的探讨甲泼尼龙联合丙种球蛋白治疗手足口病重症脑炎的疗效及预后情况。方法选择本院2017年7月至2018年6月间收治的80例手足口病合并重症脑炎患儿为研究对象,随机分为对照组和观察组,各40例。所有患儿均给予降温、体征监测、维持水电解质及酸碱平衡等基础治疗,对照组患儿给予利巴韦林、甘露醇及甲泼尼龙治疗,观察组在对照组基础上给予丙种球蛋白治疗。比较两组患儿治疗后发热、皮疹、脑膜刺激征等症状与体征消退时间,临床疗效及预后情况。结果两组均未出现明显不良反应,观察组患儿治疗后发热、皮疹及脑膜刺激征等临床症状及体征消退时间均显著早于对照组患儿(P<0.05);观察组总有效率97.50%(39/40)明显高于对照组82.50%(33/40)(P<0.05);观察组后遗症发生率15.00%(6/40)明显少于对照组35.00%(14/40)(P<0.05)。结论甲泼尼龙联合丙种球蛋白可加快促进重症脑炎手足口病患儿发热、皮疹及脑膜刺激征等临床症状及体征消退,临床疗效显著,预后良好,且用药安全,可临床推广应用。
Objective To investigate the efficacy and prognosis of methylprednisolone combined with gamma globulin in the treatment of severe encephalitis caused by hand-foot-mouth disease.Methods 80 children with hand-foot-mouth disease(HFMD)complicated with severe encephalitis were selected from July 2017 to June 2018.They were divided into control group and observation group by random number table grouping method,with 40 cases in each group.All the children were given basic treatment such as cooling,physical signs monitoring,water electrolyte maintenance and acid-base balance.The control group was given ribavirin,mannitol and methylprednisolone treatment.The observation group was given gamma globulin treatment on the basis of the control group.The remission time,clinical efficacy and prognosis of fever,rash and meningeal irritation were compared between the two groups.Results There were no obvious adverse reactions in the two groups.The clinical symptoms and signs of fever,rash and meningeal irritation in the observation group were significantly earlier than those in the control group(P<0.05);the total effective rate in the observation group was 97.50%(39/40)and 82.50%(33/40)respectively(P<0.05);the sequelae in the observation group was significantly higher than that in the control group(P<0.05).The rate of birth(15.00%)(6/40)was significantly less than that of the control group(35.00%)(14/40)(P<0.05).Conclusion Methylprednisolone combined with gamma globulin can accelerate the remission of fever,rash and meningeal irritation symptoms in children with severe encephalitis.The clinical effect is remarkable,the prognosis is good,and the medication is safe.It can be widely used in clinic.
作者
刘娟
Liu Juan(Department of Pediatrics,Songzi Maternal and Child Health Care Hospital,Songzi,Hubei,434200China)
出处
《当代医学》
2019年第24期124-126,共3页
Contemporary Medicine
关键词
甲泼尼龙
丙种球蛋白
手足口病
重症脑炎
预后
Methylprednisolone
Gamma globulin
Hand foot mouth disease
Severe encephalitis
Prognosis
