头部亚低温联合微泵输注咪达唑仑辅助治疗儿童重症病毒性脑炎临床研究  

Head Mild Hypothermia Combined with Micropump Infusion of Midazolam in the Adjuvant Treatment of Severe Viral Encephalitis in Children

作　　者：蒋绍清[1] 谭少宏[1] 叶泽忠[1] Jiang Shaoqing;Tan Shaohong;Ye Zezhong(Health Hospital for Women and Children of Yulin in Guangxi Zhuang Autonomous Region, Guangxi Yulin 537000, China)

机构地区：[1]广西壮族自治区玉林市妇幼保健院,广西玉林537000

出　　处：《儿科药学杂志》2019年第4期20-23,共4页Journal of Pediatric Pharmacy

基　　金：玉林市科学研究与技术开发计划项目;玉林科攻20170807号

摘　　要：目的:探讨头部亚低温联合微泵输注咪达唑仑辅助治疗小儿重症病毒性脑炎的临床意义。方法:选取我院2016-2017年诊治的重症病毒性脑炎患儿80例,按随机数表法分为观察组和对照组各40例,两组患儿均给予抗病毒、脱水降颅压、糖皮质激素、维持水电解质平衡、呼吸及营养支持等常规治疗,观察组在常规治疗基础上给予亚低温联合微泵输注咪达唑仑辅助治疗。两组患儿分别于入院时和治疗2周后进行1～2 h的脑电图监测评估疗效;入院时和治疗3 d后分别采血及完善腰穿检查、格拉斯哥评分(GCS评分)。结果:观察组总有效率为95.00%,高于对照组的72.50%(P<0.05)。观察组治疗2周后脑电图正常率为82.50%,高于对照组的30.00%(P<0.05)。观察组患儿的退热时间、意识恢复时间及抽搐、脑膜刺激征、锥体束征、肢体活动障碍消失时间均短于对照组(P均<0.05)。观察组患儿治疗3 d后的血糖、血乳酸、脑脊液压力、脑脊液葡萄糖、脑脊液蛋白、GCS评分均优于对照组(P均<0.05)。结论:头部亚低温联合咪达唑仑辅助治疗小儿病毒性脑炎对患儿有较好的脑保护作用。Objective: To investigate the clinical significance of head mild hypothermia combined with micropump infusion of midazolam in the adjuvant treatment of severe viral encephalitis in children. Methods: Totally 80 children with severe viral encephalitis admitted into our hospital from 2016 to 2017 were extracted to be divided into the observation group and the control group via the random number table, with 40 cases in each group. Both groups were given conventional treatment such as antiviral, dehydration and intracranial pressure, glucocorticoids, maintenance of water and electrolyte balance, and respiratory and nutritional support. The observation group received mild hypothermia combined with micropump infusion of midazolam on the basis of conventional treatment. EEG was monitored for 1-2 h after admission and 2 weeks after treatment. At the time of admission and after 3 d of treatment, blood was collected and the lumbar puncture examination and Glasgow score (GCS score) were performed. Results: The total effective rate of the observation group was 95.00%, higher than that of the control group 72.50%(P<0.05). The normal rate of EEG in the observation group was 82.50% after treatment for 2 weeks, higher than that in the control group 30.00%(P<0.05). The relief time of fever, recovery time of consciousness, disappearance time of convulsions, meningeal irritation, pyramidal tract sign and limb dysfunction in the observation group were shorter than those in the control group (P<0.05). After treatment of 3 d, the blood glucose, blood lactate, cerebrospinal fluid pressure, cerebrospinal fluid glucose, cerebrospinal fluid protein and GCS scores of the observation group were better than those of the control group (P<0.05). Conclusion: Head mild hypothermia combined with micropump infusion of midazolam in the adjuvant treatment of severe viral encephalitis in children has better brain protective effects.

关 键 词：亚低温 病毒性脑炎 咪达唑仑 脑电图 

分 类 号：R748[医药卫生—神经病学与精神病学]