甘露醇联合地塞米松治疗早期重症手足口病临床分析

EFFECT OF MANNITOL COMBINED WITH DEXAMETHASONE ON EARLY SEVERE HAND-FOOT-MOUTH DISEASE

目的 回顾性分析应用甘露醇联合地塞米松治疗对早期手足口病病情的影响,寻找阻止早期重症手足口病向危重症发展的方法。方法 选取2010年1月1日~2014年11月31日期间住院手足口病（重型）患儿140例,根据治疗方式分为对照组（40例）和实验组（100例）。对照组实施常规治疗和甘露醇治疗,实验组在对照组的基础上,给予甘露醇联合地塞米松治疗,观察、比较两组患儿的临床指标和治疗结果。结果 实验组的临床指标（神经系统症状消失时间,呼吸、循环系统症状消失时间,血糖恢复正常时间,白细胞恢复正常时间,退热时间）均优于对照组（P〈0.05）。实验组在发展3A期或3B期率、死亡率分别为4%、2%,低于对照组,治愈率为94%,明显高于对照组（P〈0.05）;两组患儿的住院时间差异无统计学意义（P〉0.05）。结论对于手足口病的患者早期使用甘露醇联合地塞米松进行治疗对于控制病情能够起到很好的疗效,能促进患儿症状尽早缓解,防止病情向危重方向进展,可于基层医院广泛推广,以提高手足口病抢救的成功率。

Objective To analyze the effect of early application of mannitol combined with dexamethasone on hand -foot - mouth disease, in order to find the method for preventing development from early to critical cases. Methods 140 cases with severe hand foot and mouth disease, which was admitted in our hospital during January 1, 2010 to November 31, 2014 were selected as the research subjects and divided into the experimental group （ 100 cases） and the control group （40 cases） randomly. The control group used conventional and mannitol treatment and the experimental group treated with mannitol combined with dexamethasone treatment on the basis of conventional treat- ment. Clinical indexes and the treatment results of the two groups were compared. Results The clinical indexes of experimental group （nervous system symptoms, respiratory and circulatory system symptoms disappearance time, re- covery time of blood glucose and white blood cell, defervescence time） were better than the control group （ P 〈 O. 05 ）. In the experimental group, the development of 3A phase or 3B phase rate and mortality rates were 4% , 2% respectively, lower than that of the control group, and the cure rate was 94%, significantly higher than the control group （ P 〈 0. 05 ）. There was no significant difference in hospital stays between the two groups （ P 〉 0. 05 ）. Conclusion The mannitol combined with dexamethasone in the treatment of hand - foot - mouth disease has very good curative effect in controlling the condition as well as remission of symptoms as soon as possible. It can prevent illness progress and can be widely applied in basic - level hospitals to increase the successful rescue rate of treating hand - foot - mouth disease.