丙种球蛋白与美罗培南联合治疗新生儿败血症的效果研究

Effect of Combination of Gamma Globulin and Meropenem on Neonatal Sepsis

目的 探讨新生儿败血症(neonatal septicemia, NS)应用丙种球蛋白与美罗培南联合治疗取得的效果。方法 方便选取2018年1月—2020年12月福建医科大学附属南平第一医院儿科收治的196例NS患儿为研究对象,按照随机数表法将其分为对照组(98例)与研究组(98例)。对照组应用美罗培南治疗,研究组应用丙种球蛋白与美罗培南联合治疗。针对两组治疗效果、症状与体征改善时间、免疫功能指标,以及不良反应进行比较。结果 研究组治疗的总有效率为96.94%,高于对照组的87.76%,差异有统计学意义(χ^(2)=5.848,P<0.05)。研究组拒奶改善时间、病原菌转阴时间、体温恢复正常时间与住院时间均短于对照组,差异有统计学意义(P<0.05)。治疗前,两组患儿免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、免疫球蛋白G(IgG)指标比较,差异无统计学意义(P>0.05);治疗后,研究组患儿IgA、IgM、IgG指标均高于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 NS患儿应用丙种球蛋白与美罗培南联合治疗效果确切,能够有效加快临床症状与体征改善时间,提高免疫功能,安全性较佳。

Objective To investigate the use of gamma globulin and meropenem in neonatal septicemia(NS).Methods A total of 196 children with NS admitted to the Department of Pediatrics of Nanping First Hospital Affiliated to Fujian Medical University from January 2018 to December 2020 were conveniently selected as the research objects,and were divided into control group(98 cases)and study group(98 cases)according to random number table method.The con⁃trol group was treated with meropenem,and the study group was treated with gamma globulin combined with merope⁃nem.The therapeutic effect,improvement time of symptoms and signs,immune function indexes,and adverse reac⁃tions were compared between the two groups.Results The total effective rate of 96.94%in the study group was higher than that in the control group(87.76%),the difference was statistically significant(χ^(2)=5.848,P<0.05).The improve⁃ment time of milk rejection,the time of pathogenic bacteria turning negative,the time of body temperature returning to normal and the length of hospital stay in the study group were shorter than those in the control group,and the differ⁃ence was statistically significant(P<0.05).Before treatment,the indexes of immunoglobulin A(IgA),immunoglobulin M(IgM)and immunoglobulin G(IgG)were not statistically significant between the two groups(P>0.05).After treat⁃ment,the levels of IgA,IgM and IgG in the study group were higher than those in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The combination of gamma globulin and meropenem in the treatment of NS chil⁃dren has a definite effect,which can effectively accelerate the improvement time of clinical symptoms and signs and improve immune function,with good safety,and has the value of clinical promotion.