摘要
目的探讨重症化脓性脑膜炎(PM)患儿采用地塞米松与美罗培南联合治疗的方式及临床价值。方法选取2019年1月至2020年5月在河南省济源市人民医院收治的重症PM患儿90例,按照随机数字表法分成观察组(n=45)与对照组(n=45),对照组采用单纯美罗培南治疗,观察组采用地塞米松与美罗培南联合治疗,对两组患儿治疗效果、症状改善情况、炎性因子水平、脑脊液指标及不良反应发生率进行比较。结果观察组患者临床疗效显著高于对照组,差异有统计学意义(P<0.05)。观察组患者症状改善时间、住院时间显著短于对照组,差异有统计学意义(P<0.05)。治疗前观察组患者炎性因子指标无统计学意义(P>0.05),治疗后观察组患者肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、降钙素原(PCT)水平显著低于对照组,差异有统计学意义(P<0.05)。治疗前两组患者脑脊液指标差异无统计学意义(P>0.05),治疗后观察组患者一氧化氮(NO)、硫化氢(H2S)水平低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论重症PM患儿采用地塞米松与美罗培南联合治疗的方式对提高临床疗效、缓解炎症反应有明显效果,可改善患儿临床症状及脑脊液指标水平。
Objective To investigate the effect of combined treatment with dexamethasone and meropenem on clinical efficacy and inflammatory factor levels in children with severe suppurative meningitis(PM).Methods A total of 90 children with severe PM admitted in the People's Hospital of Jiyuan City,Henan Province from January 2019 to May 2020 were selected,they were divided into the observation group(n=45)and the control group(n=45)according to the random number table method.The control group was treated with meropenem alone,and the observation group was treated with dexamethasone combined with meropenem.The treatment effect,symptom improvement,inflammatory factor levels,cerebrospinal fluid indexes and incidence of adverse reactions were compared between the two groups.Results The clinical efficacy of the observation group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).The symptom improvement time and hospitalization time of the observation group were significantly shorter than those of the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistical significance in inflammatory factor indexes of the two groups(P>0.05).After treatment,the levels of tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and procalcitonin(PCT)in observation group were significantly lower than those in control group,the differences were statistically significant(P<0.05).There was no significant difference in cerebrospinal fluid indexes between the two groups before treatment(P>0.05).After treatment,the levels of nitric oxide(NO)and hydrogen sulfide(H2S)in observation group were lower than those in control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The treatment of dexamethasone combined with meropenem in children with severe PM has obvious effects on improving clinical efficacy and relieving inflammatory response,and can improve the clinical symptoms and cerebrospinal fluid index levels of children.
作者
李娜
郑伟伟
蒋春晖
LI Na;ZHENG Weiwei;JIANG Chunhui(Department of Pediatrics,People's Hospital of Jiyuan City,Jiyuan Henan 459000,China)
出处
《临床研究》
2022年第4期82-85,共4页
Clinical Research
关键词
地塞米松
美罗培南
重症化脓性脑膜炎
临床疗效
炎性因子
dexamethasone
meropenem
severe suppurative meningitis
clinical efficacy
inflammatory factors
