静脉注射用人血丙种球蛋白在儿童严重烧伤感染的应用价值

Intravenous Immuneglobulin in the Treatment of Severe Burn Infection in Children

目的:总结使用静脉注射用人血丙种球蛋白(IVIG)治疗儿童严重烧伤感染的经验。方法:采用回顾性研究方法,收集2013-2017年在我院住院治疗的24例严重烧伤感染患儿的临床资料,根据是否应用IVIG治疗分为IVIG组14例和对照组10例,比较分析两组患儿的血常规、肝肾功能、C反应蛋白(CRP)、降钙素原(PCT)、创面培养及血培养等。结果:两组患儿均为Ⅱ度烧伤,年龄、体质量、烧伤面积比较差异均无统计学意义(P均>0.05)。治疗前,IVIG组患儿的体温及CRP水平均高于对照组(P均<0.05),WBC、中性粒细胞比例、血小板计数、PCT与对照组比较差异均无统计学意义(P均>0.05);治疗后,IVIG组的体温、CRP及PCT水平较治疗前降低(P均<0.05)。结论:面积深度相当的烧伤患儿,可能出现对烧伤程度不同的炎症反应;IVIG能有效改善严重烧伤患儿的感染症状,降低炎性指标水平。

Objective:To summarize the experience of intravenous immuneglobulin(IVIG)in the treatment of children with severe burn infection.Methods:Clinical data of 24 hospitalized children with severe burn infection from 2013 to 2017 were retrospectively analyzed.According to the application of IVIG treatment,all patients were divided into 14 cases in the IVIG group and 10 cases in the control group.The routine blood test,liver and kidney function,C-reactive protein(CRP),procalcitonin(PCT),bacterial,fungal and blood culture of wound surface of two groups were compared and analyzed.Results:All cases were second degree burn,there was no significant difference between two groups in the age,body mass and burn area(P>0.05).Before treatment,the temperature and CRP levels in the IVIG group were significantly higher than those of the control group(P<0.05),yet there was no statistically significant difference in WBC,neutrophil ratio,platelet count,and PCT compared with the control group(P>0.05).After treatment,the body temperature,CRP and PCT levels in the IVIG group were lower than those before treatment(P<0.05).Conclusion:Children with burns of the same area and depth may have inflammatory reactions to different degrees of burn.IVIG can effectively improve the infection symptoms of severe burn and reduce the inflammatory index.