早期应用甘露醇联合注射用甲泼尼龙琥珀酸钠在小儿重症手足口病病情控制中的作用

Effect of Early Application of Mannitol combined with Methylprednisolone in the Control of Severe Hand,Footand MouthDisease in Children

目的 探讨早期应用甘露醇联合注射用甲泼尼龙琥珀酸钠在小儿重症手足口病(HFMD)病情控制中的作用。方法 选取2015年1月至2018年12月吉安市中心人民医院收治的104例HFMD患儿作为研究对象,按随机数字表法分为对照组与观察组,各52例。对照组在常规治疗基础上加用甘露醇治疗,观察组在常规治疗基础上加用甘露醇联合注射用甲泼尼龙琥珀酸钠治疗。疗程结束后评估两组临床疗效,于治疗前后检测患儿血清C反应蛋白(CRP)和肝功能相关指标水平,记录其临床症状消失时间和不良反应发生情况。结果 观察组治疗有效率高于对照组(P<0.05)。治疗前两组血清CRP及丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)水平比较差异无统计学意义(P>0.05);治疗后,两组血清CRP、ALT、AST水平下降(P<0.05),且观察组血清CRP、ALT、AST水平低于对照组(P<0.05)。观察组发热、肢体抖动、脑膜刺激征、皮肤疱疹、易惊消失时间均明显短于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率(11.54%vs.7.69%)比较差异无统计学意义(P>0.05)。结论 早期应用甘露醇联合注射用甲泼尼龙琥珀酸钠治疗小儿重症HFMD效果显著,能降低炎症因子水平,改善患儿肝功能及临床症状,且安全可靠。

Objective To explore the effect of early application of mannitol combined with methylprednisolone in the control of severe hand,foot and mouth disease in children.Methods 104 children with HFMD admitted to Ji'an Central People's Hospital from January 2015 to December 2018 were selected as the study subjects,and were randomly divided into a control group and an observation group using a random number table method,with 52 cases in each group.The control group was treated with mannitol on the basis of conventional treatment,and the observation group was additionally treated with mannitol combined with methylprednisolone on the basis of conventional treatment.After the course of treatment,the clinical efficacy of the two groups was evaluated,and the levels of serum C-reactive protein(CRP)and liver function-related indexes were detected before and after treatment,and the disappearance time of clinical symptoms and the occurrence of adverse reactions were recorded.Results The effective rate of treatment in the observation group was higher than that in the control group(P<0.05).There was no significant difference in serum CRP,alanine transaminase(ALT)and aspartate transaminase(AST)levels between the two groups before treatment(P>0.05);After treatment,the serum CRP,ALT,and AST levels in both groups decreased(P<0.05),and the serum CRP,ALT,and AST levels in the observation group were lower than those in the control group(P<0.05).The disappearance time of fever,limb tremor,meningeal irritation sign,skin herpes,and susceptibility to shock in the observation group was significantly shorter than that in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(11.54%vs.7.69%)(P>0.05).Conclusion Early application of mannitol combined with methylprednisolone in the treatment of severe hand,foot and mouth disease in children has a significant effect,can reduce the level of inflammatory factors,improve the liver function and clinical symptoms of children,and is safe and reliable.