糖皮质激素治疗儿童重症腺病毒肺炎的疗效观察  

Clinical curative effects of glucocorticoid in treatment of severe adenovirus pneumonia in children

作　　者：刘新锋[1] 李丹丹 李攀[1] 郎艳美 马铮 王莎 石艳玺 LIU Xinfeng;LI Dandan;LI Pan(Hebei Provincial Children’s Hospital Affiliated to Hebei Medical University,Hebei,Shijiazhuang 050031,China)

机构地区：[1]河北省儿童医院,石家庄市050031

出　　处：《河北医药》2021年第10期1548-1550,共3页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题(编号:20190821)。

摘　　要：目的研究糖皮质激素在治疗儿童重症腺病毒肺炎中的临床疗效。方法选择2016年5月至2019年5月收治的儿童重症腺病毒肺炎患儿200例,随机分为治疗组和对照组,每组100例。2组患儿均给予常规对症治疗以及免疫球蛋白支持治疗,治疗组在对照组治疗的基础上给予甲泼尼龙琥珀酸钠治疗,比较2组患儿发热持续时间、肺部啰音吸收时间、影像学恢复时间、住院时间、闭塞性细支气管炎(BO)的发生率及预后;观察2组患儿治疗24 h、72 h、7 d后的有效率。结果治疗组较对照组平均发热时间短、肺部啰音消失时间快、影像学吸收时间短、住院时间缩短,差异均有统计学意义(P<0.05);2组治疗72 h后有效率最高,差异有统计学意义(P<0.05),治疗24 h及7 d后的有效率差异无统计学意义(P>0.05),出院后随访12个月,2组BO发生率差异无统计学意义(P>0.05)。结论糖皮质激素治疗儿童重症腺病毒肺炎有效而且安全,BO发生率无增加。Objective To investigate the clinical curative effects of glucocorticoid in treatment of severe adenovirus pneumonia(SAP)in children.Methods A total of 200 children patients with SAP who were admitted and treated in our hospital from 2016 to May 2019 were enrolled in the study,who were randomly divided into observation group(n=100)and control group(n=100).The patients in both groups were given conventional symptomatic treatment and immunoglobulin supportive treatment.The patients in observation group,on the basis of control group,were treated by methylprednisolone sodium succinate.The duration of fever,absorption time of lung rales,and recovery time of imaging examination,length of staying in hospital,incidence and prognosis of bronchiolitis obliterans(BO)as well as the effective rates at 24 h,72h,and 7d after treatment were observed and compared between the two groups.Results The average duration of fever,absorption time of lung rales,disappearance time of imaging examination,and hospital stay in observation group were significantly shorter than thos e in control group(P<0.05).The effective rate was the highest at 72h after treatment in both groups(P<0.05),however,there were no significant differences in the effective rates at 24 h and 7d after treatment between the two groups(P>0.05).There was no significant difference in the incidence of BO at 12 months after discharge between the two groups(P>0.05).Conclusion Glucocorticoid is effective and safe in treatment of SAP in children,without increasing the incidence of BO.

关 键 词：糖皮质激素 儿童 重症腺病毒肺炎 

分 类 号：R563.1[医药卫生—呼吸系统]