阿昔洛韦联合高压氧治疗小儿急性病毒性脑炎的最佳时机

Effect and optimal occasion of the treatment on acute children viral encephalitis by hyperbaric oxygen combined with acyclovir

目的探讨阿昔洛韦联合高压氧对小儿急性病毒性脑炎的临床疗效及联用的最佳时机。方法 117例急性病毒性脑炎患儿随机分为观察(n=59)和对照(n=58)两组。所有患者入院后予以支持对症综合处理。对照组52例患儿予抗病毒药物阿昔洛韦治疗2～3周;观察组在此基础上,分别与发病不同时期联合高压氧治疗3～4个疗程。观察比较两组间及联合治疗不同时期的疗效对比以及远期后遗症的发生率。结果观察组总有效率(88.14%)较对照组(60.34%)增加,脑电图异常率(11.86%)低于对照组(25.86%),P<0.05。发病至入舱时间≤4 d患儿的治疗有效率(100%)优于4～10 d(88.89%)及>10d(73.33%)者,差异有统计学意义。随访一年以上的后遗症发生率观察组(7.02%)也显著低于对照组(20.37%)。结论阿昔洛韦联合高压氧用于小儿急性病毒性脑炎的治疗,疗效确切,值得推广。发病早期即开始联合治疗是提高有效率的关键。

Objective To evaluate the effect and optimal occasion of the treatment on children viral encephalitis by hyperbaric oxygen combined with acyclovir. Methods 117 children who diagnosed viral encephalitis were randomly divided into 2 groups,the control group（n=58） was given acyclovir for 2 to 3 weeks,while the observe group（n=59） was treated with hyperbaric oxygen for 3~4 course based on patient＇s condition.Besides,both groups were given the same supporting therapy.We compared the effectiveness of different treatment and different optimal occasion of the hyperbaric oxygen with acyclovir,as well as the after effect. Results After the therapy,total effectiveness of observe group（88.14%） was higher than the control（60.34%） while the abnormality of ECG（11.86% vs 25.86%） was lower（P0.05）.Treatment in time of no more than 4 d after development of disease could get the best effectiveness（100% vs 88.89%,73.33%）.Incidence of after effect of the observe group（7.02%） was also significantly lower than the control（20.37%）.Conclusions Hyperbaric oxygen combined with acyclovir is a kind of treatment which is safe and effective in children viral encephalitis and worth application.Early treatment might be critical to improve the effectiveness.