目的 探讨呋喃妥因联合头孢甲肟治疗儿童复发性尿路感染的临床疗效。方法 选取2018年8月-2020年8月在沈阳市儿童医院治疗的120例复发性尿路感染患儿，随机分为对照组（60例）和治疗组（60例）。对照组患儿静脉输注注射用盐酸头孢甲肟，每次2 g溶于生理盐水200 mL，2次/d。治疗组患儿在对照组的基础上口服呋喃妥因肠溶片，每天7 mg/kg，3次/d。两组患儿连续用药5 d。观察两组患儿临床疗效，比较治疗前后两组患儿临床症状好转时间，尿液红细胞、白细胞、鳞状上皮细胞和细菌指标，尿液白细胞介素6（IL-6）、白细胞介素8（IL-8）、肝素结合蛋白（HBP）、中性粒细胞明胶酶相关脂质运载蛋白（NGAL）水平。结果 治疗后，治疗组临床总有效率明显高于对照组（98.33%vs 83.33%，P<0.05）。治疗后，治疗组患儿临床症状好转时间明显早于对照组（P<0.05）。治疗后，两组患儿尿液红细胞、白细胞、鳞状上皮细胞、细菌水平均明显降低（P<0.05），且治疗组明显低于对照组（P<0.05）。治疗后，两组患儿尿液中IL-6、IL-8、HBP、NGAL水平明显下降（P<0.05），且治疗组均明显低于对照组（P<0.05）。结论 呋喃妥因肠溶片与注射用盐酸头孢甲肟联合治疗儿童复发性尿路感染效果显著，临床症状好转迅速，能有效抑制细菌增殖，降低炎性反应，治疗和预防尿路感染。

Objective To investigate the efficacy of nitrofurantoin combined with cefmenoxime in treatment of recurrent urinary tract infections in children. Methods Children (120 cases) with recurrent urinary tract infections in Shenyang Children's Hospital from August 2018 to August 2020 were randomly divided into control (60 cases) and treatment (60 cases) groups. Children in the control group were iv administered with Cefmenoxime Hydrochloride for injection, 2 g dissolved in normal saline 200 mL once, twice daily. Children in the treatment group were po administered with Nitrofurantoin Enteric-coated Tablets, 7 mg/(kg·d), three times daily. Children in two groups were treated for 1 month. After treatment, the clinical efficacy was evaluated, the improvement of clinical symptoms, plasma fibrinogen, the improvement time of clinical symptoms, the indexes of red blood cells, white blood cells, squamous epithelial cells and bacteria in urine, the levels of IL-6, IL-8, HBP, and NGAL in urine in two groups before and after treatment were compared. Results After treatment, the clinical effective rate in the treatment group was significantly higher than that of the control group (98.33% vs 83.33%, P<0.05). After treatment, the improvement time of clinical symptoms in the treatment group was significantly earlier than that in the control group (P<0.05). After treatment, the indexes of red blood cells, white blood cells, squamous epithelial cells, and bacteria in urine of the two groups were significantly decreased (P<0.05), and these indexes in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the indexes levels of IL-6, IL-8, HBP, and NGAL in urine of the two groups were significantly decreased, and which in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion The combination of Nitrofurantoin Enteric-coated Tablets and Cefmenoxime Hydrochloride for injection has a significant therapeutic effect, and which can rapidly improve clinical symptoms, effectively inhibit bacterial proliferation, reduce inflammatory reaction, treat and prevent urinary tract infection.

R983