摘要
目的:观察地塞米松联合美罗培南治疗难治性化脓性脑膜炎患儿的效果。方法:回顾性分析2020年10月至2023年10月该院收治的78例难治性化脓性脑膜炎患儿的临床资料,按照治疗方法不同将其分为对照组和研究组各39例。两组均予以常规治疗,在此基础上,对照组予以美罗培南治疗,研究组在对照组基础上联合地塞米松治疗,两组均治疗1周。比较两组临床疗效,临床相关指标(体温恢复正常时间、脑膜刺激征消失时间、白细胞计数恢复正常时间)水平,治疗前后炎性因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)]、血清学指标[基质金属蛋白酶-9(MMP-9)、可溶性B7同源体3(sB7-H3)]水平,以及不良反应发生率。结果:研究组治疗总有效率为94.87%(37/39),高于对照组的79.49%(31/39),差异有统计学意义(P<0.05);研究组体温恢复正常时间、脑膜刺激征消失时间、白细胞计数恢复正常时间均短于对照组,差异有统计学意义(P<0.05);治疗后,研究组CRP、TNF-α、PCT、MMP-9、sB7-H3水平均低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:地塞米松联合美罗培南治疗难治性化脓性脑膜炎患儿可提高治疗总有效率,改善临床相关指标水平,降低炎性因子、血清学指标水平,效果优于单纯美罗培南治疗。
Objective:To observe effects of Dexamethasone combined with Meropenem in treatment of children with refractory purulent meningitis.Methods:The clinical data of 78 children with refractory purulent meningitis admitted to this hospital from October 2020 to October 2023 were retrospectively analyzed.According to different treatment methods,they were divided into control group and study group,39 cases in each group.Both groups were given routine treatment.On this basis,the control group was treated with Meropenem,while the study group was treated with Dexamethasone on the basis of that of the control group.Both groups were treated for 1 week.The clinical efficacy,the levels of clinical related indexes(recovery time of body temperature,disappearance time of meningeal irritation sign,recovery time of white blood cell count),the levels of inflammatory factors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),procalcitonin(PCT)]and the serological indexes[matrix metalloproteinase-9(MMP-9),soluble B7 homolog 3(sB7-H3)]before and after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of treatment in the study group was 94.87%(37/39),which was higher than 79.49%(31/39)in the control group,and the difference was statistically significant(P<0.05).The recovery time of body temperature,the disappearance time of meningeal irritation sign and the recovery time of white blood cell count in the study group were shorter than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of CRP,TNF-α,PCT,MMP-9 and sB7-H3 in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Dexamethasone combined with Meropenem in the treatment of the children with refractory purulent meningitis can improve the total effective r
作者
文征
米小凤
WEN Zheng;MI Xiaofeng(First Ward of Department of Pediatric of Dengzhou Central Hospital,Nanyang 474150 Henan,China)
出处
《中国民康医学》
2024年第15期80-82,90,共4页
Medical Journal of Chinese People’s Health
