新生儿青霉素皮试价值的临床研究

Clinical study of new-born penicillin skin-test value

目的 :探讨青霉素皮肤过敏试验在新生儿时期应用的价值。方法 :对 148例 4d～ 2 8d新生儿采用自身配对方式 ,分别用 5 0 0 u/ m L青霉素皮试液 (实验组 )及生理盐水 (对照组 )各 0 .1m L于左右腕横纹上三指处正中顺皮纹方向皮内注射 ,2 0 min后观察结果。结果 :红晕直径实验组为 1.0 99cm± 0 .6 8cm;对照组为 1.0 6 4cm± 0 .6 91cm,两组相比 P>0 .0 5 ;4d～ 10 d、11d～ 2 0 d、2 1d～ 2 8d各日龄组间红晕直径无显著差异 (P>0 .0 5 ) ,4d～ 10 d、11d～ 2 0 d两组实验组与对照组红晕直径无差异 ;而 2 1d～ 2 8d日龄组实验组红晕直径为 1.0 45 cm± 0 .6 0 8cm,大于对照组 0 .86cm± 0 .45 2 cm (P<0 .0 5 ) ;红晕直径大于 1cm者 ,实验组为 45 .95 % ,对照组为 33.78% ;两组相比 X2 =4.5 6 6 ,P<0 .0 5。结论 :4d～ 2 0 d的新生儿青霉素皮试价值不大。 2 1d～ 2 8d新生儿青霉素皮试常用标准判断阳性者 ,应在对侧做生理盐水对照实验 ,如果二者红晕直径相等或前者小于后者应判断为假阳性。

Objective:To probe the using value in new-born stage with penicillin skin anaphylaxis experiment.Methods:148 new-borns from 4 to 28 days who were adopted auto-matched-pair method were intradermic injected along cleavage lines direction in the center of three fingernail point in the both wrists cross striation,respectively,500 u/mL penicillin skin test liquid(experimental group) and 0.1mL normal saline (control group),then observing the result after twenty minutes.Results:Areola diameter (unit:cm)was 1.099±0.68 in the experimental group,and was 1.064±0.691 in the control group (The two group compared value P >0.05);Areola diameter hadn’t obvious difference( P >0.05) among 4 days～10 days,11 days～20 days and 21 days～28 days group.It hadn’t difference in the experimental group and control group from 4 to 10 days and 11 to 20 days group.Areola diameter (1.045±0.608) was longer in the experimental group from 21 to 28 days group than that of control group (0.86±0.452) P <0.05;Experimental group is 45.95 % and control group 33.78 % when arcola diameter was more than 1 cm.The result was X 2 =4.566 P <0.05 when the two groups were compared.Result:It’s no value for 4 to 20 days new-borns using penicillin skin test.If penicillin skin test is positive according to habitually using for the new-borns of 21 to 28 days,the control experiment should be done with normal saline in the both wrists.It should be fake positive if the both areola diameters are equal or the former is longer than the later.