阿昔洛韦治疗小儿急性上呼吸道感染的不良反应分析

Retrospective Analysis of Adverse Reactions of Acyclovir in the Treatment of Acute Upper Respiratory Tract Infection in Children

目的探讨阿昔洛韦治疗小儿急性上呼吸道感染（AUPI）患儿不良反应发生情况及特点,为临床儿科合用使用阿昔洛韦提供参考。方法回顾性选取2010年1月至2015年10月茂名市电白区妇幼保健院收治的4782例AURI患儿的病例资料,所有患儿均采用阿昔洛韦进行治疗,采集并统计患者一般情况、不良反应发生时间、涉及器官及临床表现、联合用药情况、处理情况和转归。结果 4782例患儿中,发生不良反应58例,占1.2%,其中发生不良反应患儿以4~9岁为主;第1次使用阿昔洛韦注射液发生不良反应患儿20例,发生率为34.5%,连续使用阿昔洛韦注射液2次以上才出现不良反应38例,发生率为65.5%;其中发生不良反应最快为静脉滴注后2 min,最迟为第8天;阿昔洛韦最主要的不良反应为急性肾衰竭,其次为皮肤反应;58例患儿均有联合用药情况,其中以联合2种药物为主,其次为联合1种药物;58例患儿经停药或对症处理后,48例治愈,占83.8%;9例好转,占15.5%;1例转入肾内科接受治疗,经专科治疗后好转出院。结论临床使用阿昔洛韦治疗AUPI患儿应严格掌握本药使用原则,了解患儿全身情况,遵循个体化用药,注意用药剂量及滴注速度,以减少不良反应发生。

Objective To explore the situation and characteristics of acyclovir in the treatment of AUPI children with adverse reaction occurred,for pediatric clinical combined with acyclovir was used to provide a reference.Methods 2010 January 2015 October Maoming Dianbai District Maternal and child health care hospital of 4782 cases AURI children were selected.All patients were treated with acyclovir treatment,collection and statistics of patients in general,adverse reactions occurred time,involved organs and clinical manifestations,combined drugs,treatment and prognosis.Results In 4782 cases,58 cases of adverse reactions,which accounted for 1.2%,the adverse reaction in children 4 to 9 years of age;first Aciclovir Injection 20 cases of adverse reactions in patients,the incidence rate of 34.5%,continuous use of Aciclovir Injection more than 2 times before the appearance of 38 cases of adverse reactions,the incidence rate was 65.5%;the occurrence of adverse reactions the fastest after intravenous infusion of 2 min,the latest eighth days;the main adverse reactions of acyclovir for acute renal failure,followed by skin reaction;the children were combined in 58 cases,which combined with 2 kinds of drugs,followed by a combination of 1 drugs;58 patients after discontinuation or symptomatic after treatment,48 cases were cured,accounting for 83.8%;9 cases improved,accounting for 15.5%;1 cases were transferred to renal Department of internal medicine treated by specialist treatment after discharged.Conclusion Clinical use of acyclovir in the treatment of AUPI children should strictly control the drug use principle,to understand the general situation of the children,individualized medication,pay attention to the dosage and the infusion speed,to reduce the incidence of adverse reactions.