摘要
目的比较全身亚低温疗法和选择性头部亚低温疗法联合肠内营养治疗中枢神经系统感染患儿的疗效及安全性。方法回顾性分析37例中枢神经系统感染患儿的临床资料,按治疗方式不同分为观察组(19例)和对照组(18例)。两组均给予肠内营养治疗,在此基础上,观察组应用全身亚低温疗法治疗,对照组应用选择性头部亚低温疗法治疗。比较两组患儿退热时间、抽搐消失时间、重症医学科住院时间、不良反应发生情况及治疗前后实验室检查指标、差值。结果观察组退热时间、抽搐消失时间及重症医学科住院时间分别为(9.79±8.46)h、(4.79±4.97)d、(11.53±7.90)d,与对照组的(9.00±6.11)h、(6.61±5.10)d、(12.06±5.44)d比较,差异无统计学意义(P>0.05)。两组患儿治疗3 d后超敏C反应蛋白(hs-CRP)、血糖、血乳酸、脑脊液蛋白及脑脊液葡萄糖水平均低于入院时,差异均具有统计学意义(P<0.05);两组患儿治疗前后超敏C反应蛋白、血糖、血乳酸、脑脊液蛋白及脑脊液葡萄糖水平及其差值组间比较,差异均无统计学意义(P>0.05)。观察组腹泻、腹胀发生率分别为57.89%、63.16%,均高于对照组的22.22%、27.78%,差异具有统计学意义(P<0.05);两组呕吐发生率差异无统计学意义(P>0.05)。结论选择性头部亚低温疗法和全身亚低温疗法联合肠内营养治疗中枢神经系统感染患儿均有显著效果,其退热时间、抽搐消失时间、重症医学科住院时间也无差异,但选择性头部亚低温疗法可降低患儿腹泻、腹胀发生率,安全性优于全身亚低温疗法。
Objective To compare the efficacy and safety of whole-body mild hypothermia and selective head mild hypothermia combined with enteral nutrition in the treatment of children with central nervous system infection.Methods The clinical data of 37 children with central nervous system infection were retrospectively analyzed,and they were divided into an observation group(19 cases)and a control group(18 cases).Both groups were treated with enteral nutrition.On this basis,the observation group was treated with whole-body mild hypothermia,and the control group was treated with selective head mild hypothermia.The time of fever reduction,the time of convulsion disappearance,the intensive care unit length of stay,the occurrence of adverse reactions,the laboratory indicators and their difference before and after treatment between the two groups were compared.Results The time of fever reduction,the time of convulsion disappearance and the intensive care unit length of stay in the observation group were(9.79±8.46)h,(4.79±4.97)d and(11.53±7.90)d,and those in the control group were(9.00±6.11)h,(6.61±5.10)d and(12.06±5.44)d.There was no significant difference between the two groups(P>0.05).The levels of hypersensitive C-reactive protein(hs-CRP),blood glucose,blood lactic acid,cerebrospinal fluid protein and cerebrospinal fluid glucose after 3 d of treatment were lower than those at admission,with statistically significant difference(P<0.05).There was no statistical significance in the levels of hypersensitive C-reactive protein,blood glucose,blood lactic acid,cerebrospinal fluid protein and cerebrospinal fluid glucose and their differences before and after treatment between the two groups(P>0.05).The incidence of diarrhea and abdominal distension in the observation group were 57.89%and 63.16%,which were higher than 22.22%and 27.78%in the control group,with statistically significant difference(P<0.05).There was no statistically significant difference in the incidence of vomiting between the two groups(P>0.05).Conclusion Both selective head mild hypothermia therapy and whole-body mild hypothermia combined with enteral nutrition have significant effects in the treatment of children with central nervous system infection,but there are no significant differences in time of fever reduction,time of convulsion disappearance and intensive care unit length of stay.Compared with whole-body mild hypothermia,selective head mild hypothermia has better safety in reducing the incidence of diarrhea and abdominal distension in children.
作者
林紫
陈丽
陈佳
肖玮
张玉红
LIN Zi;CHEN Li;CHEN Jia(Intensive Care Unit,Wuhan Children's Hospital,Tongji Medical College,Huazhong University of Science&Technology,Wuhan 430000,China)
出处
《中国实用医药》
2024年第7期32-36,共5页
China Practical Medicine
关键词
全身亚低温疗法
选择性头部亚低温疗法
肠内营养
中枢神经系统感染
Whole-body mild hypothermia
Selective head mild hypothermia
Enteral nutrition
Central nervous system infection
