大剂量丙种球蛋白联合甲泼尼龙治疗小儿手足口病合并神经系统损害临床观察

CLINICAL OBSERVATION OF HIGH DOSE OF GAMMA GLOBULIN COMBINED WITH METHYLPREDNISOLONE TREATMENT ON CHILDREN WITH HAND FOOT AND MOUTH DISEASE WITH NERVOUS SYSTEM DAMAGE

目的观察采用大剂量丙种球蛋白联合甲泼尼龙治疗小儿手足口病合并神经系统损害的临床疗效。方法选取2012年1月~2014年1月收治的90例小儿手足口病合并神经系统损害患者作为研究对象,将其随机分为观察组与对照组各45例。对照组给予小剂量甲泼尼龙、利巴韦林与20%甘露醇治疗,观察组在对照组基础上加用大剂量的丙种球蛋白（IVIG）治疗,观察比较两组患儿的发热持续时间、神经系统症状恢复时间、病程等。结果观察组患者各项指标均优于对照组（p〈0.05）,有统计学意义,其中两组持续发热时间分别为（4.31±1.23）、（5.67±1.01）d,神经系统症状恢复时间分别为（2.08±1.23）、（2.93±1.31）d,病程分别为（4.31±1.39）、（6.01±1.34）d;观察组治疗总有效率为97.78%,对照组总有效率为77.78%,观察组明显高于对照组（p〈0.05）,具有统计学意义。结论采用大剂量丙种球蛋白联合甲泼尼龙治疗小儿手足口病合并神经系统损害的临床疗效显著,能够有效缩短患儿持续发热时间、神经症状恢复时间与病程,值得在临床中推广。

Objective To observe the clinical effect of large dose of gamma globulin combined with methyl- prednisolone in treatment of children with hand foot and mouth disease with nervous system damage. Methods We selected 90 cases of children with hand foot in our hospital from 2012 January to 2014 January containing mouth dis- ease with nervous system damage in patients as the research object, then they were randomly divided into observation group and control group with 45 cases in each group. The control group was given small dose of methylprednisolone, Leigh Bhave Lin with 20% mannitol treatment; The observation group in the control group based on the use of gamma globulin high dose （IVIG） treatment, were compared between the two groups of children with duration of fever, nerv- ous system symptom recovery duration, etc. Results Two groups of patients with persistent fever time was （4.31 ± 1.23） d, （5.67 ± 1.01） d;Nervous system symptom recovery time was （2.08 ± 1.23） d, （2.93 ± 1.31） d; Course of disease were （4.31 ± 1.39） d, （6.01 ± 1.34） d, and the patients in observation group each indicators are better than the control group （p 〈0.05）. There is statistical significance. The observation group the total effec- tive rate was 97.78% , and total effective rate of the control group was 77.78%. The observation group was signifi- cantly higher than the control group （p 〈 0.05 ）. Conclusion Using large dose of gamma globulin combined with methylprednisolone clinical curative effect of the treatment of children with hand foot and mouth disease with nervous system damage was significant, and it can effectively shorten the children fever time, neural symptom recovery time and duration. It is worthy to be popularized in clinic.