不同剂量糖皮质激素辅助治疗小儿难治性肺炎支原体肺炎合并肺外并发症的效果对比

Effect comparison of different doses of glucocorticoid in the adjuvant treatment of pediatric refractory Mycoplasma pneumonia complicated with extrapulmonary complications

目的比较不同剂量糖皮质激素辅助治疗小儿难治性肺炎支原体肺炎合并肺外并发症的效果。方法选取2016年1～12月我院收治的100例难治性肺炎支原体肺炎合并肺外并发症患儿作为研究对象,根据电脑随机分组方式将其分为对照组和观察组,每组各50例。对照组患儿给予小剂量糖皮质激素辅助治疗,观察组患儿给予常规剂量糖皮质激素辅助治疗。比较两组患儿的临床治疗效果、临床症状改善时间(咳嗽消失时间、喘息消失时间、体温恢复正常时间、肺部啰音消失时间、X线摄片阴影消失时间)、住院时间及相关实验室指标[C反应蛋白(CRP)、D-二聚体、乳酸脱氢酶(LDH)、红细胞沉降率(ESR)]。结果观察组患儿的治疗总有效率为98.00%,显著高于对照组的74.00%,差异有统计学意义(P<0.05)。观察组患儿的咳嗽消失时间、喘息消失时间、体温恢复正常时间、肺部啰音消失时间、X线摄片阴影消失时间及住院时间均短于对照组,差异有统计学意义(P<0.05)。观察组患儿的CRP、D-二聚体、LDH水平及ESR均低于对照组,差异有统计学意义(P<0.05)。结论常规剂量糖皮质激素辅助治疗小儿难治性肺炎支原体肺炎合并肺外并发症的临床效果十分显著,不仅能够缩短患儿的住院时间,还能改善其各项临床症状和实验指标,值得研究。

Objective To compare the effect of different doses of glucocorticoid in the adjuvant treatment of pediatric refractory Mycoplasma pneumonia complicated with extrapulmonary complications.Methods One hundred children with refractory Mycoplasma pneumonia complicated with extrapulmonary complications admitted to our hospital from January to December 2016 were selected as research objects.They were divided into the control group and the observation group according to the computer randomization grouping method,with 50 cases in each group.In the control group,a small dose of glucocorticoid as an adjuvant therapy was used,and in the observation group,a conventional dose of glucocorticoid as an adjuvant therapy was adopted.The clinical treatment effect,clinical symptom improvement time(cough disappearance time,wheezing disappearance time,body temperature recovery normal time,lung voice disappearance time,X-ray shadow disappearance time),hospitalization time and related laboratory indicators(C-reactive protein[CRP],D-dimer,lactate dehydrogenase[LDH],erythrocyte sedimentation rate[ESR])were compared between the two groups.Results The total effective rate of treatment in the observation group was 98.00%,which was significantly higher than that in the control group(74.00%),and the difference was statistically significant(P<0.05).The cough disappearance time,wheezing disappearance time,body temperature recovery normal time,lung voice disappearance time,X-ray shadow disappearance time,and hospitalization time in the observation group were shorter those in the control group,and the differences were statistically significant(P<0.05).The levels of CRP,D-dimer,LDH and ESR in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Conventional doses of glucocorticoid in the treatment of refractory Mycoplasma pneumonia complicated with extrapulmonary complications has a remarkable clinical effect,which not only can shorten the hospital stay,but also improve the clinical symptoms and laboratory indicators,and is worthy of study.