| 摘要: |
| 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。 |
| 关键词: 静脉注射用人免疫球蛋白 手足口病 病毒性脑炎 |
| DOI：10.13407/j.cnki.Jpp.1672-108X.2017.09.010 |
|
| 基金项目: |
|
| human intravenous immunoglobulin; hand, foot and mouth disease; viral encephalitis |
| Wu Huilian |
| (The Third People's Hospital of Hainan Province, Hainan Sanya 572000, China)) |
| Abstract: |
| Objective: To investigate the efficacy and feasibility of human intravenous immunoglobulin in the treatment of hand, foot and mouth disease combined with viral encephalitis. Methods: Retrospectively analyzed the clinical data of 136 children with hand, foot and mouth disease combined with encephalitis in our hospital from January 2013 to January 2016. According to whether the use of human intravenous immunoglobulin treatment, they were divided into the observation group of 72 cases and control group of 64 cases. All the children were given conventional treatment, such as cooling, anti-virus (ribavirin 10~15 mg/( kg·d)), anti-inflammation (dexamethasone 0.2~0.5 mg/(kg·d)), reducing intracranial pressure (20% mannitol 0.25~1.00 g/kg), strengthening nutrition support, maintaining water and electrolyte balance, the children combined with bacterial infection were given cefixime treatment. Based on the conventional treatment, the observation group was given human intravenous immunoglobulin 1.0 mg/(kg·d), continuous
application of 2~5 d. Results: The total effective rate of the observation group was 94.4%, the control group was 82.8%, the difference was statistically significant (P<0.05). The time of body temperature recovery, the time of skin rash disappearance, the symptom disappearance time of nervous system and hospitalization time of 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, significantly lower than the control group ((5.9±1.6) d, (6.8±2.5)d, (4.9±2.0) d and (11.5±3.5) d), the differences were statistically significant (P<0.05). After treatment, serum IL-6 and IL-8 in two groups were significantly decreased (P<0.05), and the decrease range of observation group were significantly larger than the control group, the differences were statistically significant (P<0.05). Conclusion: Human intravenous immunoglobulin for the treatment of hand, foot and mouth disease combined with viral encephalitis has significant effect, it can effectively improve the clinical symptoms of children, promote the rehabilitation of the disease. |
| Key words: human intravenous immunoglobulin hand, foot and mouth disease viral encephalitis |
