CAJ | 학술논문

目的评价大剂量甲基强的松龙冲击(HDMP)和静注丙种球蛋白(IVIG)联合治疗小儿脱髓鞘疾病的疗效。方法25例脱髓鞘疾病的住院患儿随机分为观察组和常规组。观察组15例应用HDMP和IVIG联合治疗。常规组10例应用IVIG和地塞米松治疗。结果观察组24h总有效率100％，常规组24h总有效率50％；观察组肌力、行走恢复正常所需时间平均15.89天，常规组27.56天，两组均有显著性差异(P＜0.01)。结论HDMP和IVIG联合治疗小儿脱髓鞘疾病，疗效显著，值得临床常规应用。
목적평개대제량갑기강적송룡충격(HDMP)화정주병충구단백(IVIG)연합치료소인탈수초질병적료효。방법25례탈수초질병적주원환인수궤분위관찰조화상규조。관찰조15례응용HDMP화IVIG연합치료。상규조10례응용IVIG화지새미송치료。결과관찰조24h총유효솔100％，상규조24h총유효솔50％；관찰조기력、행주회복정상소수시간평균15.89천，상규조27.56천，량조균유현저성차이(P＜0.01)。결론HDMP화IVIG연합치료소인탈수초질병，료효현저，치득림상상규응용。
Objective To study the character of respiratory mechanics insevere respiratory distress syndrome and its clinical significance. Methods We measured the indices of respiratory mechanics,chest radiographsand blood gas in 17 newborns with respiratory distress syndrome(RDS). Results The indices of respiratory mechanics in 17 newborns with RDS showed:Crs were correlated with severity and outcome of the illness. Crs lower than 0.3ml/cmH2O· kg indicated severe illness. Crs lower than 0.2ml/cmH2O· kg was associated with high mortality rate. Crs were negatively correlated with oxygenated index(OI) ( r = - 0.948) and a linear regressive relation was found ( OI = 64.73 - 82.70Crs). Chest X -ray manifestations were negatively correlated with Crs (r = -0.768). 90.9% of the patients were successfully weaned from the ventilator when mean value of Crs was (0.683 + 0. 110)m/(crnH2O·kg). Conclusion Crs monitoring is of clinical significance in evaluating the severity of RDS, directing mechanical ventilation management, reducing frequency of blood gas analysis and radiographs and predicting outcome.