糖皮质激素治疗类百日咳综合征的临床分析

Clinical analysis of glucocorticoid in the treatment of pertussis-like syndrome

目的探讨糖皮质激素治疗类百日咳综合征的临床疗效。方法选择2014年3月至2016年3月本院收治的52例类百日咳综合征患儿作为研究对象,随机分为对照组和观察组,各26例。对照组常规行呼吸支持、抗感染、支气管解痉等治疗,观察组在对照组基础上增加糖皮质激素治疗,比较两组患儿临床症状和体征的改善情况,以及并发症及不良反应发生情况。结果观察组患儿入院72 h内吸痰次数、体温升高时间、痉挛性咳嗽时间、肺部体征消失时间、白细胞升高时间、症状缓解时间均显著少于对照组(P<0.05)。观察组住院时间略少于对照组,无显著差异(P>0.05)。对照组并发症发生率(19.23%)显著高于观察组(0.00%)(P<0.05)。两组均未见不良反应。结论类百日咳综合征应用糖皮质激素治疗,可有效改善患儿痉挛性咳嗽、肺部体征及临床症状,有助于快速缓解患儿病情,进一步改善预后。

Objective To investigate the clinical efficacy of glucocorticoid in the treatment of pertussis-like syndrome. Methods Fifty-two cases of patients with pertussis-like syndrome admitted in our hospital from March 2014 to March 2016 were randomly divided into control group and observation group, with 26 cases in each group. The control group received the conventional respiratory support, anti-infective, bronchodilation treatment, while the observation group received additional glucocorticoid treatment on the basis of the control group. The clinical improvement of symptom and signs, complications and adverse reactions were compared between the two groups. Results The frequency of sputum aspiration within 72 hours admitted to hospital, the elevation time of temperature, spastic coughing time, disappearing of pulmonary symptoms time, white blood cells increasing time, and symptom remission time in the observation group were significantly shorter than that in the control group （P〈0.05）. The hospitalization time of observation group was slightly less than that of control group （P〉 0.05）. The incidence rate of complication in the control group （19.23%） was significantly higher than that of observation group （0.00%） （P〈0.05）. No adverse reactions were found in both the two groups. Conclusion Glucocorticoid can effectively improve spastic cough, pulmonary signs and clinical symptoms in children with pertussis-like syndrome. It can alleviate the condition of the children and improve the prognosis.