不同剂量静脉用免疫球蛋白治疗手足口病合并脑炎的效果观察

Effect observation of different dose of intravenous immunoglobulin in the treatment of hand-foot-mouth disease combined with encephalitis

目的：观察不同剂量静脉用免疫球蛋白治疗手足口病合并脑炎的临床效果。方法150例手足口病合并脑炎患儿随机分成3组,每组50例,3组患儿均实施常规综合疗法和护理,给予0.3～0.4 g/kg静脉用免疫球蛋白静脉滴注,连用3d者作为普通剂量组；给予1g/kg静脉用免疫球蛋白静脉滴注,连用2d者作为大剂量组,不使用静脉用免疫球蛋白者作为对照组。比较3组的退热天数、皮疹消褪时间、惊颤消失时间、脑膜刺激征消失时间、住院天数以及治疗有效率和无效率。结果与对照组比较,普通剂量组的退热天数、皮疹消褪时间、惊颤消失时间、脑膜刺激征消失时间、住院天数无明显缩短,差异无统计学意义（P＞0.05）；大剂量组则较对照组明显缩短,两组比较差异有统计学意义（P＜0.05）；普通剂量组的治疗有效率（86%）和无效率（14%）与对照组的治疗有效率（80%）和无效率（20%）比较,差异无统计学意义（P＞0.05）；大剂量组治疗有效率（96%）和无效率（4%）与对照组比较,差异有统计学意义（P＜0.05）。结论大剂量静脉用免疫球蛋白及护理干预治疗小儿手足口病合并脑炎具有良好效果。

Objective To observe the effect of different dose of intravenous immunoglobulin in the treatment of hand-foot-mouth disease combined with encephalitis. Methods 150 cases with hand foot and mouth disease combined with encephalitis were randomly divided into three groups,50 cases in each group.Three groups were impienmented routine therapy and nursing,and given 0.3-0.4 g/kg immunoglobulin for intravenous drip for 3 days as the normal dose group,1 g/kg immunoglobulin intravenous drip for 2 days as the high dose group,without the use of intravenous immune globulin as control group.Fever time,rash fade time,start disappearing time,meningeal irritation sign disappearing time,length of hospital stay,and the effective rate of treatment and inefficiency were compared between the three groups after treat-ment. Results Compared with the control group,fever time,shocked disappearance time,meningeal irritation sign disap-pearing time,hospitalization time of normal dose groups was not shortened,there was no significant differences between the two groups（P＆gt;0.05）,those of high dose group was significantly shorter than those of the control group,with statistical difference （P〈0.05）.In the Normal dose group,the treatment efficiency was 86%,inefficiency was 14%,the treatment effi-ciency and inefficiency of the control group was 80% and 20% respectively,compared with the control group,there was no significant differences（P〉0.05）.The treatment efficiency and inefficiency of high dose group was 96%and 4%,compared with the control group,there was significant differences（P〈0.05）. Conclusion High dose Intravenous immunoglobulin and nursing intervention in the treatment of children with hand-foot-mouth disease combined with encephalitis has obvious curative effect.