甘露醇联合地塞米松治疗早期重症手足口病临床观察

Clinical effect of mannitol and dexamethasone in the treatment of early severe hand,foot and mouth disease

目的重症手足口病是危及儿童生命健康的重要疾病之一,易引发肺水肿、心力衰竭和脑膜炎等并发症,目前尚无特效药物治疗,以对症治疗为主。为防止病情向危重症和极危重症发展,及时有效的治疗具有重要意义。本研究探究甘露醇联合地塞米松治疗早期重症手足口病的临床疗效。方法选取郑州大学附属儿童医院2017-10-01-2018-08-31收治的早期重症手足口病患儿作为研究对象,根据组间性别、年龄和病程等因素均衡可比的原则,在不同治疗方法中选择观察组与对照组,各61例。对照组采用甘露醇治疗,观察组在此基础上应用地塞米松治疗,比较两组治疗总有效率、住院时间和临床症状消失时间以及不良反应。结果观察组治疗总有效率为98.36%,高于对照组的88.52%,差异有统计学意义,χ2=4.816,P=0.028。观察组惊跳或抖动消失时间、脑膜刺激征消失时间、退热时间以及住院时间均短于对照组,差异有统计学意义,均P<0.001。观察组不良反应发生率为6.56%,与对照组的8.20%比较,差异无统计学意义,χ2=0.120,P=0.729。结论甘露醇与地塞米松联合治疗早期重症手足口病效果确切,能促进患儿神经系统症状缓解,缩短住院时间,且联合用药安全性高。

OBJECTIVE Severe hand,foot and mouth disease is one of the important diseases endangering children’s life and health.It is easy to cause pulmonary edema,heart failure,meningitis and other complications.At present,there is no specific drug treatment,mainly symptomatic treatment.In order to prevent the disease from developing to critical illness and extremely critical illness,timely and effective treatment is of great clinical significance.This study was to investigate the efficacy of mannitol combined with dexamethasone in the treatment of early severe hand foot mouth disease.METHODS A total of 122 cases of early severe hand,foot and mouth disease were selected from October 1,2017 to August 31,2018 in Children’s Hospital Affiliated to Zhengzhou University.According to the treatment method,the control group was treated with mannitol,while the observation group was treated with dexamethasone on the basis of the control group.The total effective rate and hospitalization time of the two groups were compared.RESULTS The total effective rate of the observation group was 98.36%,higher than that of the control group 88.52%,and the difference was statistically significant(χ2=4.816,P=0.028).The disappearance time of shock or tremor,the disappearance time of meningeal irritation the sign,the time of fever abatement and hospitalization of the observation group were shorter than those of control group,the difference was statistically significant(all P<0.001).There was was no significant difference in the incidence of adverse reactions between the observation group and the control group(6.56%vs 8.20%),χ2=0.120,P=0.729.CONCLUSION The combination of mannitol and dexamethasone in the treatment of early severe hand,foot and mouth disease is effective,promotes the relief of nervous system symptoms,shortens hospitalization time,and has high safety.