注射用甲泼尼龙琥珀酸钠联合注射用头孢哌酮钠舒巴坦钠治疗儿童脓毒症的效果观察

Effect of methylprednisolone sodium succinate injection combined with cefoperazone sodium and sulbactam sodium injection on sepsis in children

目的分析注射用甲泼尼龙琥珀酸钠联合注射用头孢哌酮钠舒巴坦钠治疗儿童脓毒症的临床效果。方法抽取2019年8月至2022年8月河南科技大学第一附属医院收治的儿童脓毒症患儿78例,依据随机数字表法分为对照组与观察组,每组39例。对照组采用注射用头孢哌酮钠舒巴坦钠进行治疗,观察组在对照组基础上加用注射用甲泼尼龙琥珀酸进行治疗。比较两组临床疗效、病情严重程度[小儿危重病例评分(PCIS),急性生理与慢性健康评分Ⅱ(APACHEⅡ)评分]、肾功能[血肌酐(Scr),尿素氮(BUN)]、炎性因子[降钙素原(PCT)、C反应蛋白(CRP)]水平及免疫功能[免疫球蛋白A(IgA),免疫球蛋白M(IgM)]。结果观察组总有效率(94.87%,37/39)高于对照组(76.92%,30/39),P<0.05。治疗后,观察组PCIS评分高于对照组,APACHEⅡ评分低于对照组(P<0.05)。治疗后,观察组Scr、BUN、CRP、PCT水平低于对照组(P<0.05),IgA、IgM水平高于对照组(P<0.05)。结论注射用甲泼尼龙琥珀酸钠联合注射用头孢哌酮钠舒巴坦钠治疗儿童脓毒症效果显著,可减轻肾功能损害,改善炎性反应和免疫功能,减轻病情严重程度。

Objective To analyze the therapeutic effect of methylprednisolone sodium succinate injection combined with cefoperazone sodium and sulbactam sodium injection on sepsis in children.Methods A total of 78 children with sepsis treated in the First Affiliated Hospital of Henan University of Science and Technology from August 2019 to August 2022 were selected and divided into control group and observation group according to random number table method,with 39 cases in each group.The control group was given cefoperazone sodium and sulbactam sodium for injection,while the observation group was given methylprednisolone sodium succinate for injection based on the treatment of the control group.The curative effect,severity of the disease assessed by pediatric critical illness score(PCIS)and acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,renal function assessed by serum creatinine(Scr)and blood urea nitrogen(BUN),inflammatory factors,including procalcitonin(PCT)and C-reactive protein(CRP),and immune function assessed by immunoglobulin A(IgA)and immunoglobulin M(IgM)of the two groups were compared.Results The total effective rate of the observation group(94.87%,37/39)was higher than that of the control group(76.92%,30/39),P<0.05.After treatment,the PCIS score of the observation group was higher than that of the control group,the APACHEⅡscore was lower than that of the control group(P<0.05).After treatment,the levels of Scr,BUN,CRP and PCT in the observation group were lower than those in the control group,while the levels of IgA and IgM in the observation group were higher than those in the control group(P<0.05).Conclusions Methylprednisolone sodium succinate injection combined with cefoperazone sodium and sulbactam sodium injection is effective in the treatment of sepsis in children.It can reduce renal function damage,improve inflammatory response and immune function,and reduce the severity of the disease.