丙种球蛋白对极低出生体重儿预防感染的临床研究

Clinical study of effect of gamma globulin on prevention of infections in very low birth weight children

目的评估探讨预防性应用丙种球蛋白对于极低出生体重儿抗感染能力的影响,降低临床极低出生体重儿感染率。方法选取2012年3月-2014年3月63例极低出生体重儿为研究对象,随机分为两组,对照组31例采取保暖、氧疗、抗感染等常规治疗法,治疗组32例在该基础上于生后1周内静脉滴注丙种球蛋白,2次/周,3周后,观察比较两组患儿感染率、并发症发生率、抗菌药物使用时间、治疗有效率及住院时间等指标。结果治疗组与对照组患儿感染率分别为25.0%、38.7%,差异均有统计学意义(P<0.05);3周治疗结束时两组患儿各指标均较治疗前明显改善,但治疗组较对照组改善更明显,差异均有统计学意义(P<0.05);治疗组与对照组患儿治疗总有效率分别为78.1%、58.1%、治疗组优于对照组,差异均有统计学意义(P<0.05);治疗组与对照组患儿治疗期间并发症发生率分别为28.1%、48.4%,差异有统计学意义(P<0.05)。结论预防性应用丙种球蛋白可提高极低出生体重儿抗感染能力,疗效显著,不良反应相对较小,可在临床推广和应用。

OBJECTIVE To evaluate the effect of prophylactic use of gamma globulin on prevention of infections in the very low birth weight children so as to reduce the incidence of infections in the very low birth weight children.METHODS A total of 63 very low birth weight children who were treated in the hospital from Mar 2012 to Mar2014were recruited as the study objects and randomly divided into two groups;the control group was treated with conventional therapies,including keeping warm,oxygen therapy,and anti-infection,while the treatment group was given the intravenous injection of gamma globulin within one week after birth on the basis of the control group,twice per week;three weeks later,the infection rate,incidence of complications,time of use of antibiotics,effective rate of treatment,and hospitalization duration were observed and compared between the two groups.RESULTS The incidence of infections was 25.0%in the treatment group,38.7%in the control group,there was significant difference（P〈0.05）.Three weeks after the treatment,the indicators of both groups were significantly improved,but they were improved more significantly in the treatment than in the control group,there was significant difference（P〈0.05）.The total effective rate of treatment was 78.1% in the treatment group,higher than58.1%in the control group,there was significant difference（P〈0.05）.The incidence of complications was28.1%in the treatment group during therapy,48.4%in the control group,there was significant difference（P〈0.05）.CONCLUSIONThe prophylactic use of gamma globulin can significantly improve the effect on prevention of infections in the very low birth weight children,with the effect remarkable,the incidence of adverse reactions low,and it is worthy to be promoted in the hospital.