CAJ | 학술논문

目的：探讨早期足量使用甲泼尼龙联合丙种球蛋白治疗重型手足口病的临床疗效。方法选取本院2012年-2014年住院部重型手足口病患儿123例，随机分为4组。治疗1组（甲强）25例，治疗2组（静丙）30例，治疗3组（甲强+静丙）38例，对照组30例。4组年龄、性别及发病病程差异无统计学意义（P>0.05）。对照组给予一般常规治疗；治疗组在一般常规治疗基础上，治疗1组加用甲泼尼龙（甲强2mg/（kg·d），疗程3-5d）；治疗2组加用丙种球蛋白（静丙1g/（kg·d），疗程2d）；治疗3组联合甲强及静丙辅助治疗。4组同时配合控制颅内压、对症支持治疗，观察四组疗效。结果治疗3组（甲强+静丙）治愈率高于其他各组（P均<0.05）；在发热消退时间、神经系统症状、临床治愈时间、无效或转危重型控制方面均优于其他各组（P<0.05），并未增加相关并发症。结论早期足量使用甲泼尼龙联合丙种球蛋白治疗重型手足口病疗效安全、有效，值得临床推荐使用。
목적：탐토조기족량사용갑발니룡연합병충구단백치료중형수족구병적림상료효。방법선취본원2012년-2014년주원부중형수족구병환인123례，수궤분위4조。치료1조（갑강）25례，치료2조（정병）30례，치료3조（갑강+정병）38례，대조조30례。4조년령、성별급발병병정차이무통계학의의（P>0.05）。대조조급여일반상규치료；치료조재일반상규치료기출상，치료1조가용갑발니룡（갑강2mg/（kg·d），료정3-5d）；치료2조가용병충구단백（정병1g/（kg·d），료정2d）；치료3조연합갑강급정병보조치료。4조동시배합공제로내압、대증지지치료，관찰사조료효。결과치료3조（갑강+정병）치유솔고우기타각조（P균<0.05）；재발열소퇴시간、신경계통증상、림상치유시간、무효혹전위중형공제방면균우우기타각조（P<0.05），병미증가상관병발증。결론조기족량사용갑발니룡연합병충구단백치료중형수족구병료효안전、유효，치득림상추천사용。
Objective To observe the efficacy of early enough methylprednisone combined with immunoglobulin in treatments of children with severe hand,foot and mouth disease. Methods From 2012 to 2014 in our hospital inpatient department in 123 children with Hand,Foot And Mouth Disease. The patients were divided into four group by random,the treatment group 1 of 25 cases,the treatment group 2 of 30 cases,the treatment group 3 of 38cases;30 cases in the control group. There was no significant statistical difference in age,sex and disease course among four grous (P>0.05). Patients of four groups all accepted symptomatic treatment,supportive therapy and the treatment of control intracranial pressure. And patients in treatment group 3 received the treatment of early,enough methylprednisone combined with immunoglobulin,the treatment group 1 with methylprednisone,the treatment group 2 with immunoglobulin,whereas patients in the control group were received conventional therapy. Results Cura-tive rate of the treatment group 3 was better than that of the other groups (P<0.05),otherwise incidence rate of critical illness was less than that of the other groups .The control time of fever,neurological symptoms,time of clinical cure was shorter than that of the other groups (P<0.05). and no more recent or long-term treatment-related adverse reaction in treatment group 3. Conclusion Early enough methylprednisone combined with immunoglobulin is safe effective,in treaing severe hand,foot and mouth disease, and worthy to recommend its clinical application.