目的 探究氢化可的松联合阿昔洛韦在治疗小儿重症病毒性脑炎中的临床疗效。方法 选择2017年1月—2019年1月于濮阳市油田总医院接受治疗的98例重症病毒性脑炎患儿作为研究对象，按照随机数字表法将患者分为对照组和观察组，每组各49例。对照组患儿iv阿昔洛韦注射液，应用剂量为40 mg/d，2次/d，治疗时间为14 d；观察组患儿在对照组基础上iv氢化可的松注射液，应用剂量为100 mg/d，3～5 d后减一次半量，激素治疗时间为7 d。观察两组患儿的临床疗效，比较两组患儿体温恢复时间、惊厥消失时间、肢体瘫痪恢复时间、昏迷恢复时间和血清神经元特异性烯醇化酶（NSE）水平。结果 治疗后，观察组治疗总有效率为87.76%，显著高于对照组的71.43%，两组总有效率比较差异具有统计学意义（P<0.05）。治疗后，观察组体温恢复时间、惊厥消失时间、肢体瘫痪恢复时间、昏迷恢复时间均短于对照组，两组比较差异具有统计学意义（P<0.05）。治疗第3、5、10天时，观察组NSE水平均显著低于对照组，两组比较差异具有统计学意义（P<0.05）。结论 氢化可的松联合阿昔洛韦对小儿重症病毒性脑炎具有较好的治疗效果，能够加快患儿临床症状改善，降低其血清NSE水平，同时治疗安全性较高，值得进行临床推广。

Objective To explore the efficacy of hydrocortisone combined with acyclovir in treatment of severe viral encephalitis in children. Methods 98 children with severe viral encephalitis in Puyang Oilfield General Hospital from January 2017 to January 2019 were divided into control and observation group according to random number table method, and each group had 49 cases. Children in the control group were iv administered with Aciclovir Injection at 40 mg/d for twice daily, and the treatment time was 14 d. Children in the observation group were iv administered with Hydrocortisone Injection on the basis of control group, and the dose was 100 mg/d. After 3-5 d, the dose was reduced by half once, and the duration of hormone therapy was 7 d. After treatment, the clinical efficacy in two groups were observed, and the temperature recovery time, convulsion disappearance time, limb paralysis recovery time, coma recovery time, and the serum NSE level in two groups were compared. Results After treatment, the total effective rate in the observation group was 87.76%, which was significantly higher than 71.43% in the control group, the difference between two groups was statistically significant (P<0.05). After treatment, the time of temperature recovery, convulsion disappearance, limb paralysis recovery, and coma recovery in the observation group were significantly shorter than those in the control group, the difference between two groups was statistically significant (P<0.05). At the 3rd, 5th and 10th day of treatment, the NSE level in the observation group was significantly lower than that in the control group, and the difference between the two groups was statistically significant (P<0.05).Conclusion Hydrocortisone combined with acyclovir has a good therapeutic effect on severe viral encephalitis in children, which can accelerate the improvement of clinical symptoms and reduce the serum NSE level in children. Meanwhile, the treatment is relatively safe, and worthy of clinical promotion.

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