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[摘要]
目的 探讨硫酸镁联合甲泼尼龙治疗小儿毛细支气管炎的临床效果。方法 选取2015年10月—2017年10月朝阳市第二医院收治的118例毛细支气管炎患儿,随机分为对照组和治疗组,每组各59例。对照组静脉滴注注射用甲泼尼龙琥珀酸钠,2 mg/kg加入5%葡萄糖溶液100 mL充分稀释后给药,1次/d。治疗组在对照组治疗基础上静脉滴注硫酸镁注射液,25 mg/kg用5%葡萄糖溶液均匀稀释至浓度为1.25%后给药,滴注时间约2 h/次,2次/d。两组均连续治疗5 d。观察两组的临床疗效和一般临床症状消失时间,比较两组治疗前后酸碱度(pH)、血氧饱和度(SaO2)、二氧化碳分压(pCO2)、肺表面活性蛋白A、D(SP-A、SP-D)、嗜酸粒细胞阳离子蛋白(ECP)、纤维蛋白原(FIB)、红细胞聚集指数(RCAI)、血浆黏度(PV)的变化情况。结果 治疗后,对照组和治疗组的总有效率分别为76.27%、91.53%,两组比较差异有统计学意义(P < 0.05)。治疗后,治疗组喘憋、咳嗽、哮鸣音及湿罗音消失时间均显著短于对照组,两组比较差异具有统计学意义(P < 0.05)。治疗后,两组pH值、SaO2均明显增加,但pCO2、SP-A、SP-D、ECP、FIB、RCAI、PV显著降低,同组治疗前后比较差异有统计学意义(P < 0.05);治疗后,治疗组pH值、SaO2高于对照组,pCO2、SP-A、SP-D、ECP、FIB、RCAI、PV低于对照组,两组比较差异有统计学意义(P < 0.05)。对照组和治疗组的不良反应发生率分别为3.4%、5.1%,两组不良反应发生率比较差异无统计学意义。结论 硫酸镁联合甲泼尼龙治疗小儿毛细支气管炎具有较好的临床疗效,可较快消除患儿症状,改善血气状况,调节血流变状态,具有一定的临床推广应用价值。
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[Abstract]
Objective To investigate the clinical effect of magnesium sulfate combined with methylprednisolone in treatment of children with capillary bronchitis. Methods Children (118 cases) with capillary bronchitis in Second Hospital of Chaoyang from October 2015 to October 2017 were randomly divided into control (59 cases) and treatment (59 cases) groups. Children in the control group were iv administered with Methylprednisolone Sodium Succinate for injection, 2 mg/kg added into 5% glucose solution 100 mL, once daily. Children in the treatment group were iv administered with Magnesium Sulfate Injection on the basis of the control group, 25 mg/kg was diluted with 5% glucose solution to the concentration of 1.25%, and the infusion time was about 2 h/time, twice daily. Patients in two groups were treated for 5 d. After treatment, the clinical efficacy and general clinical symptoms of the two groups were observed, and the changes of pH, SaO2, pCO2, SP-A, SP-D, ECP, FIB, RCAI, and PV in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 76.27% and 91.53%, respectively, and there was difference between two groups (P < 0.05). After treatment, the disappearance time of asthma, cough, wheezing and wet sound in the treatment group was significantly shorter than that in the control group, and there was difference between two groups (P < 0.05). After treatment, pH and SaO2 in two groups increased significantly, but pCO2, SP-A, SP-D, ECP, FIB, RCAI, and PV decreased significantly, and the difference was statistically significant in the same group (P < 0.05). After treatment, pH and SaO2 in the treatment group were higher than those in the control group, but pH, SaO2, pCO2, SP-A, SP-D, ECP, FIB, RCAI, and PV lower than those in the control group, and there was difference between two groups (P < 0.05). The incidence of adverse reactions in the control and treatment groups were 3.4% and 5.1%, respectively, and there was no difference between two groups. Conclusion Magnesium sulfate combined with methylprednisolone has clinical curative effect in treatment of children with capillary bronchitis, and can eliminate the symptom quickly, and can improve the blood gas condition, also can adjust the blood flow condition, which has a certain clinical application value.
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