静脉丙种球蛋白联合纳洛酮治疗乙型脑炎43例疗效分析  

Analysis of Phleboclysis ofγ-Globulin Combined With Naloxone in 43 Encephalitis B Children Treatment

作　　者：石明芳[1] 蔡苗[1] 陈颖[1] 吕勇彬[1] 宗小敏[1] 杨介梅[1] 

机构地区：[1]四川省宜宾市第一人民医院儿科,宜宾644000

出　　处：《中华妇幼临床医学杂志（电子版）》2008年第4期27-29,共3页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

摘　　要：目的观察静脉丙种球蛋白联合纳洛酮治疗乙型脑炎的疗效。方法将四川省宜宾市第一人民医院2005年10月至2007年10月收治的85例乙型脑炎患儿随机分成治疗组(43例)和对照组(42例)(分组征得患儿家属的知情同意)。对治疗组患儿在常规综合治疗的基础上,应用丙种球蛋白静脉输注[400 mg/(kg·d)],连续治疗5 d;纳洛酮每次静脉输注(0.01～0.02)mg/kg,每天1～3次,连续治疗5 d～7 d。对照组患儿采用常规综合法治疗(抗病毒治疗+营养支持+对症治疗)。结果治疗组患儿平均退热时间、抽搐时间及意识障碍持续时间较对照组明显缩短,两组比较,差异有显著意义(P<0.01);治疗组较对照组呼吸衰竭发生率明显降低,两组比较,差异有显著意义(P<0.05);治疗组治愈率显著高于对照组,两组比较,差异有显著意义(P<0.01)。对两组患儿随访半年结果显示,治疗组患儿死亡率及后遗症发生率(遗留神经精神症状体征,且脑电图及头颅磁共振检查结果异常)明显低于对照组,两组比较,差异有显著意义(P<0.05)。结论静脉丙种球蛋白联合纳洛酮治疗乙型脑炎,可通过不同环节,共同阻止脑部病变的进一步发展,较快纠正中枢神经系统功能障碍,恢复意识、减少病残、降低病死率、提高治愈率,为目前治疗乙型脑炎的有效措施。Objective To investigate the curative effect of intravenous infusion of γ-globulin combined with naloxone in the encephalitis B. Methods 85 cases of children suffered of epidemic encephalitis B were divided into the therapeutic group （43 cases, odd number） and the control group （42 cases, even number） according to their hospitalization sequence from October 2005 to October 2007 in the Department of Pediatrics, the First People＇s Hospital of Yibin with the agreement of their guardians. The therapeutic group was treated with the routine comprehensive treatment（RCT） plus γ-globulin[400 mg/ （kg·d）, intravenous infusion, for 5 days] combined with naloxone [（0.01-0.02） mg/kg per time,1-3 times per day,intravenous infusion, for 5-7 days], the control group was administered with the routine comprehensive treatment. Results The average time for pyretolysis, the convulsion and conscious disturbance in the therapeutic group was significant shorter than that of the control group with statistical significance （P〈0.01）. And the incidence of respiratory failure in the therapeutic group was lower than that in the control group （P〈0. 05）. In the follow-up with 6 months, the cure rate in the therapeutic group was significantly higher than that in the control group （P〈0.01）; the mortality and the incidence of sequelae （sustained neuro-psychiatric symptoms and abnormalities in the EEG or MRI） in the therapeutic group were strikingly lower than that in the control group （P〈0.05）. Conclusion Intravenous infusion of γ-globulin combined with naloxone in the encephalitis B can prevent the process of pars encephalica from getting worse. This therapeutic measure can also balance the function of central nervous system, regain palinesthesia efficiently, reduce the disability and enhance the cure rate. So it can be used as an effective way in the encephalitis B treatment.

关 键 词：乙型脑炎 静脉丙种球蛋白 纳洛酮 

分 类 号：R725.1[医药卫生—儿科]