抗菌药物序贯疗法治疗细菌感染所致儿童急性肠系膜淋巴结炎临床分析

Clinical Effects of Sequential Antibiotic Therapy in Treating Children With Acute Mesenteric Lymphadenitis Caused by Bacterial Infection

目的探讨抗菌药物序贯疗法治疗细菌感染所致儿童急性肠系膜淋巴结炎的临床疗效。方法选取2010年1月至2011年12月在本院确诊的细菌感染所致儿童急性肠系膜淋巴结炎患儿75例为研究对象。将其按照随机数表法分为序贯治疗组(治疗组,n=38),给予静脉滴注头孢呋辛[(50～80)mg/(kg.d)×2次/d×(3～5)d],直至腹痛消失,外周血白细胞计数及中性粒细胞比例恢复正常后,改用口服头孢呋辛酯片[20mg/(kg.d)×2次/d×(4～5)d]治疗;全程静脉给药组(对照组,n=37),仅给予静脉滴注头孢呋辛[(50～80)mg/(kg.d)×2次/d×(7～10)d](本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试对象监护人的知情同意,并与之签署临床研究知情同意书)。两组患儿的性别、年龄、外周血白细胞计数、中性粒细胞比例及血清C反应蛋白(CRP)水平等比较,差异无统计学意义(P>0.05)。结果治疗组与对照组的治疗总有效率分别为94.73%,97.30%,差异无统计学意义(P>0.05)。但治疗组平均治疗费用明显低于对照组[(346.2±49.2)元vs.(684.5±75.8)元],且差异有统计学意义(P<0.01)。两组治疗过程中无相关不良反应发生。结论抗菌药物序贯疗法治疗细菌感染所致儿童急性肠系膜淋巴结炎的疗效满意,无明显不良反应,具有治疗费用较低、依从性好与易被患儿及家属接受等优点。

Objective To observe clinical effects of sequential antibiotic therapy on children with acute mesenteric lymphadenitis caused by bacterial infection. Methods From January 2010 to December 2011, 75 children with acute mesenteric lymphadenitis caused by bacterial infection were analyzed. They were divided into 2 groups randomly. Study group （n= 38） were receiving sequential treatment by intravenous-dripped with cefuroxime [（50-80） mg/（kg . d）× （3-5） d], twice a day, until abdominal pain disappeared and peripheral white blood cells count and neutrophils ratio recovered. Then study group received cefuroxime axetil tablets orally [-20 mg/（kg . d）× （4-5）d], twice a day. Another 37 cases were included into control group who received intravenous-dripped cefuroxime only [-（50-80） mg/（kg . d） ×（7-10） d], twice a day. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Chongqing Shapingba District People＇s Hospital. Informed consent was obtained from each participates＇ parents. There had no significant difference between two groups on ages, gender, the level of serum C-reactive protein （CRP） and so on. Results The total effective rate of study group was 94. 730%, and control group was 97.30%, there has no significant difference between two groups （P〉0.05）. But the average hospitalization costs of study group was significantly less than that of control group （P〈0.01）. Conclusions Sequential antibiotic therapy in children with acute mesenteric lymphadenitis caused by bacterial infections was effective and safe with lower cost and better compliance.