大剂量免疫球蛋白联合美罗培南治疗新生儿败血症临床评价

High-Dose Gamma Globulin Combined with Meropenem in the Treatment of Neonatal Sepsis

目的探讨大剂量静脉注射免疫球蛋白(IVIG)联合美罗培南治疗新生儿败血症(NS)的临床疗效及对患儿血清胆红素和血小板水平的影响。方法选取应城市人民医院2017年1月至2018年12月收治的NS患儿160例,按随机数字表法分为对照组和观察组,各80例。两组患儿均予维持水电解质平衡、改善微循环及其他对症支持治疗,并予注射用美罗培南静脉滴注,观察组患儿加用大剂量IVIG静脉滴注。结果观察组总有效率为90.00%,明显高于对照组的77.50%(P<0.05);观察组患儿拒奶改善时间、体温稳定时间及神经症状改善时间均明显短于对照组(P<0.05);治疗后,观察组患儿血清免疫球蛋白G及血小板计数水平均明显高于对照组(P<0.05),白细胞介素6、降钙素原、C反应蛋白、总胆红素、平均血小板体积水平均明显低于对照组(P<0.05)。结论大剂量IVIG联合美罗培南治疗NS,能有效改善患儿的症状,提高机体免疫功能,缓解炎性反应,并改善胆红素和血小板水平。

Objective To investigate the clinical efficacy of high-dose gamma globulin( IVIG) combined with meropenem in the treatment of neonatal sepsis( NS) and its effect on the levels of serum bilirubin and platelet. Methods A total of 160 children with NS admitted to Yingcheng People’s Hospital from January 2017 to December 2018 were selected and divided into the control group and the observation group according to the random number table,80 cases in each group. Both groups were treated with maintaining water and electrolyte balance,improving microcirculation and other symptomatic supportive treatments. The control group was treated with meropenem,while the observation group was treated with high-dose IVIG on the basis of the control group. Results The total effective rate of the observation group was 90. 00%,which was significantly higher than 77. 50% of the control group( P < 0. 05);the improvement time of refusal milk,body temperature stabilization and neurological symptoms in the observation group was significantly shorter than that of the control group( P < 0. 05). After treatment,the levels of serum immunoglobulin G and platelet count in the observation group were significantly higher than those in the control group( P < 0. 05). The levels of interleukin-6,procalcitonin,C-reactive protein,total bilirubin,and mean platelet volume were significantly lower than those of the control group( P < 0. 05). Conclusion High-dose IVIG combined with meropenem for the treatment of NS can effectively relieve symptoms of children,improve their immune function,relieve inflammation,improve the levels of bilirubin and platelet.