中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2015年
1期
14-19
,共6页
潘宏光%李兰%钟辉%吴泽斌%张德伦
潘宏光%李蘭%鐘輝%吳澤斌%張德倫
반굉광%리란%종휘%오택빈%장덕륜
鼻窦炎%眶蜂窝织炎%治疗结果%儿童
鼻竇炎%眶蜂窩織炎%治療結果%兒童
비두염%광봉와직염%치료결과%인동
Sinusitis%Orbital cellulitis%Treatment outcome%Children
目的 探讨儿童眶蜂窝织炎的发病特点、诊断方法及治疗原则,积累抗生素应用的治疗经验.方法 对深圳市儿童医院2009年1月至2013年12月收治的20例鼻源性眶蜂窝织炎患儿的临床资料进行回顾性分析和总结.20例患儿中,年龄2个月至7.2岁,中位数年龄3.5岁;其中男13例(65％),女7例(35％).分析血清C反应蛋白(C reactive protein,CRP)、白细胞计数与患儿住院天数的关系.分析头孢哌酮钠舒巴坦钠治疗组和其他抗生素治疗组的疗效差异.采用SPSS 13.0软件进行统计学分析.结果 患儿入院时的CRP平均为(29.8±22.0) mg/L,住院时间平均为(6.3±4.1)d,二者呈正相关趋势(r=0.46,P＜0.05);入院后CRP值降至正常范围(10 mg/L)所需时间平均为(3.4±1.8)d,与住院时间呈正相关(r=0.81,P＜0.01).入院初3d内CRP能降至正常者12例,其平均住院时间为(4.3±1.7)d,入院初3d内CRP不能降至正常者8例,其平均住院时间为(9.1±5.0)d,二者差异有统计学意义(t=2.61,P＜0.05).头孢哌酮钠舒巴坦钠治疗组12例,其平均住院时间为(4.3±1.9)d,其他药物治疗组8例,其平均住院时间(9.3±4.7)d,差异有统计学意义(t=2.83,P＜0.05).本组20例患者中4例脓液细菌学培养阳性,其中3例为耐甲氧西林金黄色葡萄球菌(M RSA),1例为咽峡炎链球菌;20例患儿血培养只有1例阳性,为MRSA,与脓液培养结果一致.全部患儿经治疗后痊愈,无后遗症,无严重并发症.结论 儿童眶蜂窝织炎的早期治疗(最初3d)有效,可以缩短病程.头孢哌酮钠舒巴坦钠治疗儿童鼻源性眶蜂窝织炎有效.
目的 探討兒童眶蜂窩織炎的髮病特點、診斷方法及治療原則,積纍抗生素應用的治療經驗.方法 對深圳市兒童醫院2009年1月至2013年12月收治的20例鼻源性眶蜂窩織炎患兒的臨床資料進行迴顧性分析和總結.20例患兒中,年齡2箇月至7.2歲,中位數年齡3.5歲;其中男13例(65％),女7例(35％).分析血清C反應蛋白(C reactive protein,CRP)、白細胞計數與患兒住院天數的關繫.分析頭孢哌酮鈉舒巴坦鈉治療組和其他抗生素治療組的療效差異.採用SPSS 13.0軟件進行統計學分析.結果 患兒入院時的CRP平均為(29.8±22.0) mg/L,住院時間平均為(6.3±4.1)d,二者呈正相關趨勢(r=0.46,P＜0.05);入院後CRP值降至正常範圍(10 mg/L)所需時間平均為(3.4±1.8)d,與住院時間呈正相關(r=0.81,P＜0.01).入院初3d內CRP能降至正常者12例,其平均住院時間為(4.3±1.7)d,入院初3d內CRP不能降至正常者8例,其平均住院時間為(9.1±5.0)d,二者差異有統計學意義(t=2.61,P＜0.05).頭孢哌酮鈉舒巴坦鈉治療組12例,其平均住院時間為(4.3±1.9)d,其他藥物治療組8例,其平均住院時間(9.3±4.7)d,差異有統計學意義(t=2.83,P＜0.05).本組20例患者中4例膿液細菌學培養暘性,其中3例為耐甲氧西林金黃色葡萄毬菌(M RSA),1例為嚥峽炎鏈毬菌;20例患兒血培養隻有1例暘性,為MRSA,與膿液培養結果一緻.全部患兒經治療後痊愈,無後遺癥,無嚴重併髮癥.結論 兒童眶蜂窩織炎的早期治療(最初3d)有效,可以縮短病程.頭孢哌酮鈉舒巴坦鈉治療兒童鼻源性眶蜂窩織炎有效.
목적 탐토인동광봉와직염적발병특점、진단방법급치료원칙,적루항생소응용적치료경험.방법 대심수시인동의원2009년1월지2013년12월수치적20례비원성광봉와직염환인적림상자료진행회고성분석화총결.20례환인중,년령2개월지7.2세,중위수년령3.5세;기중남13례(65％),녀7례(35％).분석혈청C반응단백(C reactive protein,CRP)、백세포계수여환인주원천수적관계.분석두포고동납서파탄납치료조화기타항생소치료조적료효차이.채용SPSS 13.0연건진행통계학분석.결과 환인입원시적CRP평균위(29.8±22.0) mg/L,주원시간평균위(6.3±4.1)d,이자정정상관추세(r=0.46,P＜0.05);입원후CRP치강지정상범위(10 mg/L)소수시간평균위(3.4±1.8)d,여주원시간정정상관(r=0.81,P＜0.01).입원초3d내CRP능강지정상자12례,기평균주원시간위(4.3±1.7)d,입원초3d내CRP불능강지정상자8례,기평균주원시간위(9.1±5.0)d,이자차이유통계학의의(t=2.61,P＜0.05).두포고동납서파탄납치료조12례,기평균주원시간위(4.3±1.9)d,기타약물치료조8례,기평균주원시간(9.3±4.7)d,차이유통계학의의(t=2.83,P＜0.05).본조20례환자중4례농액세균학배양양성,기중3례위내갑양서림금황색포도구균(M RSA),1례위인협염련구균;20례환인혈배양지유1례양성,위MRSA,여농액배양결과일치.전부환인경치료후전유,무후유증,무엄중병발증.결론 인동광봉와직염적조기치료(최초3d)유효,가이축단병정.두포고동납서파탄납치료인동비원성광봉와직염유효.
Objective To analyze the clinical characteristics,diagnostic and treatment principle of orbital cellulitis in children,and to improve the experience of antibiotic treatment in orbital cellulites.Methods Twenty children were admitted to Shenzhen Children's Hospital with the diagnosis of nasal orbital cellulitis between January 2009 and December 2013.The children were severe enough to warrant hospital admission.There were 13(65％) males and 7 (35％)females.The median age was 3.5 years (2 months to 7.2 years).The relationship between the serum C-reactive protein (CRP),white blood cell count and the hospitalization days were analyzed.The children were divided into 2 groups:Cefoperazone Sodium and Sulbactam Sodium for injection group and other antibiotic treatment group,the difference was compared.Statistical calculation was performed using SPSS 13.0 software.Results The serum CRP [(29.8 ± 22.0) mg/L] at the time of admission had a positive correlation with the time of hospitalization[(6.3 ±4.1) d,r =0.46,P ＜ 0.05].The time of CRP decreased to normal range after admission [(3.4 ± 1.8) d] were apparently related to the hospitalization time (r =0.81,P ＜0.01).The hospital days whose CRP could be decreased to normal within 3 days [n =12,(4.3 ± 1.7) d] were significantly shorter than that in the others [n =8,(9.1 ± 5.0) d,t =2.61,P ＜ 0.05].The hospitalization of 12 cases with Cefoperazone Sodium and Sulbactam Sodium for injection[(4.3 ± 1.9) d] was shorter than that in other 8 cases with other drugs [(9.3 ± 4.7) d,t =2.83,P ＜ 0.05].Bacterial pathogens were only identified in 4 children,including 3 cases of methicillin-resistant staphylococcus aureus (MRSA),1 case of streptococcus anginosus.Only 1 case in 20 cases with positive blood culture for Staphylococcus aureus,consistented with the pus culture.Conclusions If early treatment at the first three days is valid,the course of nasal orbital cellulitis will be shorter and the orbital abscess can be prevented.Cefoperazone sulbactam and Sulbactam Sodium for injection is effective in treating pediatric orbital cellulitis.
