头孢曲松联合氨苄西林钠舒巴坦钠治疗小儿化脓性脑膜炎疗效观察

Efficacy of ceftriaxone combined with ampicillin soudium and sulbactam soudium in the treatment with purulent meningitis in children

目的:探讨头孢曲松联合氨苄西林钠舒巴坦钠治疗小儿化脓性脑膜炎的疗效。方法:86例化脓性脑膜炎患儿,数字法随机将其分为对照组和实验组,两组各43例。在基础对症治疗基础上,对照组给予氨苄西林钠舒巴坦钠静脉滴注治疗(50 mg/kg,每6 h 1次);实验组在对照组基础上联合头孢曲松静脉滴注治疗(50 mg/kg,每12 h 1次),两组患者其他辅助治疗药物用法用量均相同,均持续治疗3周。观察两组患儿临床症状体征、脑脊液生化指标的改善情况,比较两组临床疗效及不良反应发生率。结果:实验组退热时间、体温恢复正常时间、血常规和脑脊髓恢复正常时间均短于对照组,差异具有统计学意义(P <0. 05);两组治疗后脑脊液白细胞计数相较无显著差异(P> 0. 05),但实验组脑脊液蛋白质浓度显著低于对照组,脑脊液糖浓度明显高于对照组,差异均具有统计学意义(P <0. 05);实验组治疗总有效率(95. 35%)高于对照组(81. 40%),差异具有统计学意义(P <0. 05);两组治疗期间均未出现严重不良反应,仅出现少量轻微皮疹、呕吐和转氨酶升高,组间不良反应发生率相较差异无统计学意义(P> 0. 05)。结论:头孢曲松联合氨苄西林钠舒巴坦钠治疗小儿化脓性脑膜炎,有助于缓解临床症状体征和改善脑脊液指标,且联合用药并不增加不良反应,临床疗效和安全性均值得肯定。

Objective： To investigate the efficacy of ceftriaxone combined with ampicillin soudium and sulbactam soudium in the treatment of purulent meningitis in children. Methods： 86 children with pyogenic meningitis were randomly divided into control group and experimental group,43 cases in each group.The control group was treated with intravenous infusion of ampicillin soudium and sulbactam soudium,50 mg/kg,Q6h.The experimental group was treated with ceftriaxone intravenous infusion on the basis of the control group,50 mg/kg,Q12h,and the two groups of other adjuvant drugs were used in the same dosage,and all of them were continuously treated with 3w.The improvement of clinical symptoms and signs and biochemical indexes of cerebrospinal fluid in the two groups were observed,and the clinical efficacy and adverse reactions were compared. Results： In the experimental group,the time of heat recovery,the normal body temperature recovery,the blood routine and the recovery of the brain and spinal cord were shorter than the control group,the difference was statistically significant （ P 〈0.05）.The two groups of cerebrospinal fluid white blood cells count compared with no significant difference （P 〉0.05）,but the concentration of cerebrospinal fluid protein in the experimental group was significantly lower than that of the control group,the concentration of cerebrospinal fluid sugar concentration was significantly higher than that of the control group,the differences were statistically significant （ P 〈0.05）.The total effective rate of treatment in the experimental group （95.35%） was higher than that of the control group （81.40%）,the difference was statistically significant （ P 〈0.05）.There was no serious adverse reaction in the two groups during the treatment,only a small amount of mild rash,vomiting and aminotransferase increased,there was no significant difference in the incidence of adverse reactions between the two groups （ P 〉0.05）. Conclusion： Ceftriaxone combined ampicillin soudium and sulbactam soudium in the treatment of infantile purulent meningitis can help alleviate the symptoms and signs and improve the cerebrospinal fluid index,and the combination of drugs does not increase the adverse reaction,the clinical efficacy and safety are worthy of affirmation.