丙种球蛋白联合五水头孢唑林钠治疗先天性心脏病患儿术后肺部感染的临床研究

Therapeutic effects of gamma globulin combined with cefazolin sodium pentahydrate on postoperative infection of children patients with congenital heart disease

目的对先天性心脏病患儿术后肺部感染使用丙种球蛋白联合五水头孢唑林钠治疗的疗效进行分析探讨。方法先天性心脏病行手术治疗的患儿67例按照随机分配的原则分为对照组(n=34)和观察组(n=33)。2组患儿均行常规治疗,在此基础上,对照组患儿采用丙种球蛋白进行治疗,观察组患儿采用丙种球蛋白联合五水头孢唑林钠进行治疗,对2组患儿的血气指标[动脉血氧分压(PaO_2)、二氧化碳分压(PaCO_2)]、炎症指标[白细胞(WBC)计数、血清降钙素原(PCT)、血清C-反应蛋白(CRP)]、恢复时间进行对比分析。结果观察组和对照组治疗后,PaO_2水平明显升高,PaCO_2、WBC、PCT、CRP水平明显降低(P<0.05);观察组治疗后PaO_2水平高于对照组,而PaCO_2、WBC、PCT、CRP水平明显低于对照组(P<0.05);观察组非肺动脉高压患儿和肺动脉高压患儿呼吸困难消失时间,肺部啰音消失时间,X线胸片异常消失时间和平均住院时间均明显优于对照组(P<0.05)。结论对先天性心脏病患儿术后肺部感染使用丙种球蛋白联合五水头孢唑林钠治疗的疗效显著,起效快,值得在临床上进一步推广使用。

Objective To observe the therapeutic effects of gamma globulin combined with cefazolin sodium pentahydrate on postoperative infection of children patients with congenital heart disease （ CHD） . Methods Sixty-seven CHD patients with pulmonary infection after surgery who were treated in our hospital were randomly divided into control group （ n = 33） and observation group （ n =34） . The patients in both groups were given conventional treatment,in addition to that,the patients in control group were treated by gamma globulin, however, the patients in observation group were treated by gamma globulin combined with cefazolin pentahydrate injection. The blood gas indexes including arterial partial pressure of oxygen （PaO2） , partial pressure of carbon dioxide （ PaCO2 ） , inflammation indexes including WBC count, PCT, C-reactive protein （CRP） ,recovery time of disease were observed and compared between two groups. Results After treatment,Pa02 levels were obviously increased, however, the levels of PaC02, WBC, PCT, CRP were decreased in both groups （P 〈0.05 ） . After treatment the PaO2 levels in observation group were higher than those in control group,however, the levels of PaC02, WBC, PCT,CRP in observation group were significantly lower than those in control group （ P〈0 .05） . Moreover the disappearing time of dyspnea, disappearing time of pulmonary rales,X-ray abnormalities disappearing time and average length of staying in hospital in observation group were superior to those in control group （ P〈 0.05 ） . Conclusion The gamma globulin combined with cefazolin sodium pentahydrate has obvious therapeutic effects on postoperative infection of children patients with congenital heart disease,with faster onset of efficiency,therefor, which is worth using widely in clinical practice.