抗感染药物联合不同剂量肾上腺皮质激素治疗小儿重症肺炎的临床疗效观察

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英文篇名：Observation on Clinical Efficacy of Anti-infective Drugs Combined with Different Doses of Corticosteroid Hormones in the Treatment of Severe Pneumonia in Children 作者：李婷 ; 陈鹏勋 英文作者：Li Ting;Chen Peng-xun;Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University;Department of Clinical Laboratory, People's Hospital of Zhengzhou; 关键词：儿科 ; 重症感染 ; 抗感染 ; 肾上腺皮质激素 ; 临床疗效 英文关键词：Pediatrics;;Severe Infection;;Anti-infective;;Adrenocortical Hormone;;Clinical Efficacy 中文刊名：ZYYS 英文刊名：Chinese Journal of Rational Drug Use 机构：郑州大学第一附属医院药学部;郑州人民医院检验科; 出版日期：2019-02-01 出版单位：中国合理用药探索 年：2019 期：v.16;No.182 语种：中文; 页：ZYYS201902019 页数：3 CN：02 ISSN：10-1462/R 分类号：66-68

摘要

目的:探讨抗感染药物联合不同剂量肾上腺皮质激素治疗小儿重症肺炎的临床疗效。方法:选择2015年1月—2016年1月我院儿科收治的84例重症肺炎患儿为研究对象,按治疗方案的不同分为对照组和试验组,试验组又根据使用肾上腺皮质激素剂量的不同分为大剂量、中剂量和小剂量组,各21例。对照组采取常规治疗方案,试验组在对照组基础上加用不同剂量的甲泼尼龙[大剂量组6～10 mg/(kg·d),中剂量组3～5 mg/(kg·d),小剂量组1～2mg/(kg·d)],比较四组临床治疗效果及并发症发生情况。结果:大剂量组的临床治疗有效率为90.5%,中剂量组为85.7%,小剂量组为81.0%,试验组总计为85.7%,均显著高于对照组的76.2%,差异有统计学意义(P <0.05);大剂量组发生继发真菌感染1例,神经系统后遗症1例,消化道出血1例;中剂量组发生皮肤出血1例,其他组未见不良反应发生。结论:抗感染药物联合肾上腺皮质激素治疗小儿重症肺炎的临床治疗效果显著,肾上腺皮质激素剂量越高,疗效越好,但是高剂量的安全性相对较差。
        Objective: To explore the clinical efficacy of anti-infective drugs combined with different doses of corticosteroids in the treatment of severe pneumonia in children. Methods: 84 children with severe pneumonia admitted to our hospital from January 2015 to January 2016 were selected as subjects investigated and divided into a control group and an experimental group according to different treatment regimens. The children in the experimental group were further divided into a high-dose group, a medium-dose group and a low-dose group according to different doses of adrenocortical hormones, 21 cases each. The children in the control group were given a routine treatment regimen, and the children in the experimental group were given different doses of methylprednisolone [high-dose group, 6-10 mg/(kg·d); medium-dose group, 3-5 mg/(kg·d); low-dose group, 1-2 mg/(kg·d)]. The clinical effect and complications in the four groups were compared. Results: The clinical treatment effective rate was 90.5% in the highdose group, 85.7% in the middle-dose group, 81.0% in the low-dose group and 85.7% in the experimental group, which were significantly higher than 76.2% in the control group, with statistically significant differences(P<0.05). There was 1 case with secondary fungal infection, 1 case with neurological sequelae and 1 case with gastrointestinal bleeding in the high-dose group. There was 1 case with skin bleeding in the middle-dose group. No adverse reactions occurred in other groups. Conclusion: The clinical treatment effect of anti-infective drugs combined with adrenocortical hormones on severe pneumonia in children is significant. The higher the dose of adrenocortical hormones, the better the clinical efficacy, but the safety of high doses is relatively poor.

引文

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