仙人掌合潘生丁治疗流行性腮腺炎52例临床观察

<正>流行性腮腺炎是由腮腺炎病毒引起的一种急性呼吸道传染病,人群对本病普遍敏感,但好发于儿童时期,以5～9岁小儿发病率最高,一年四季均可发生,但冬春季节易于流行,临床上以腮腺的非化脓性肿胀以及疼痛为主要特征,多为双侧,也可单侧,常伴有发热及全身不适,目前尚无特效疗法,主要为对症治疗。近年来我们采用仙人掌合潘生丁治疗本病52例,取得良好的效果。现报道如下:     

五味消毒饮合小蓟饮子加减治疗小儿急性肾小球肾炎(湿热内侵证)的疗效观察

目的 探讨五味消毒饮合小蓟饮子加减治疗小儿急性肾小球肾炎(湿热内侵证)的疗效.方法 选取急性肾小球肾炎患儿102例,按随机数字表法分为两组各51例.对照组给予西医常规干预措施;观察组在对照组治疗基础上给予五味消毒饮合小蓟饮子加减内服,每日1剂.两组连续治疗2周.比较两组蛋白尿、血尿转阴及浮肿消退时间、肾功能指标24h尿...     

脐血胆红素预测新生儿病理性黄疸的价值

Objective To investigate the predictive value of umbilical cord blood bilirubin for pathological jaundice in healthy term newborns. Methods Two ml navel string vein blood of baby were collected after giving birth in the normal newborn, and the hemobilirubin was detected by accidentally oxidation method. After birth, the infant's bilirubin level was tested on the forehead by the transcutaneous bilirubinometer at 8:00 -9:00 every morning until discharging from hospital. The ration of pathological jaundice of newborn and its treatment were analyzed in different levels of cord blood hemobilirubin. Results Fifty-nine cases ( 22.96% ) with pathological jaundice were diagnosed in 257 newboms.The concentration of cord blood hemobilirubin in baby with pathological jaundice [(39.68 ±8.10) μmol/L] was significantly higher than that of the normal newborn [(30.05 ±5.51) μmol/L](P＜0.01). As the concentration of cord blood hemobilirubin was increased, the incidence of pathological jaundice was raised (P＜ 0.01), and the cases that needed to intervention treatment was increased(P＜ 0.01). Conclusion The detection of the level of cord blood hemobilirubin is not only very worthy to estimate the occurrence of pathological jaundice of newborn, but also offer reliable evidence for clinical early diagnosis and treatment.     

γ-干扰素雾化吸入治疗毛细支气管炎62例疗效分析

毛细支气管炎是婴儿期常见的下呼吸道感染性疾病，呼吸道合胞病毒（RSV）是最常见的病原，目前尚无特效的治疗方法。最近的研究表明其感染后的细胞免疫反应与疾病有关，尤其是以γ-干扰素／白介素-4（IFN-γ／IL-4）为代表的辅助性T细胞1型／辅助性T细胞2型（Th1／Th2）反应失衡参与了发病过程。因此，探讨免疫疗法对毛细支气管炎的治疗效果成为临床治疗学上的一个重要课题。我院应用γ-干扰素（IFN-γ）雾化吸入治疗毛细支气管炎患儿，疗效满意，现报道如下。     

血浆心肌肌钙蛋白Ⅰ和脑钠肽联合检测对小儿肺炎合并心力衰竭的诊断价值

目的 探讨血浆心肌肌钙蛋白Ⅰ （cTnI）和脑钠肽（BNP）联合检测对小儿肺炎合并心力衰竭的诊断价值.方法 选择肺炎合并心力衰竭患儿（心衰组）、同期肺炎急性期患儿（肺炎组）和健康体检儿童（对照组）各30例.心衰组分别在急性期（心衰发作后6～24 h）和恢复期（心衰控制后5～7d）检测cTnI和BNP,并与肺炎组和对照组对照分析.结果 心衰组急性期cTnI和BNP水平显著高于肺炎组和对照组（F=5.303、4.632,均P＜0.05）,肺炎组与对照组cTn1和BNP水平差异无统计学意义（P＞0.05）.心衰组恢复期cTnI和BNP较急性期明显降低（t=4.291、5.393,均P＜0.05）,但与肺炎组合与对照组比较差异无统计学意义（P＞0.05）.结论 联合检测血浆cTnI和BNP是判断小儿肺炎是否合并心衰较为可靠的诊断指标.     

双歧杆菌、嗜酸乳杆菌、肠球菌三联活菌散剂治疗婴幼儿肺炎抗生素相关性腹泻的临床观察

目的 观察双歧杆菌、嗜酸乳杆菌、肠球菌三联活菌散剂在婴幼儿肺炎抗生素相关性腹泻治疗中的作用.方法 将146例肺炎抗生素相关性腹泻的患儿,随机分为观察组85例和对照组61例.对照组在常规治疗基础上给予蒙脱石散剂口服,观察组在对照组治疗基础上加用双歧杆菌、嗜酸乳杆菌、肠球菌三联活菌散剂.观察两组疗效、腹泻停止时间以及平均住院时间等指标.结果 观察组显效率61.2%,治疗总有效率92.9%,均显著高于对照组的显效率32.8%和治疗总有效率70.5%（均P〈0.05）.观察组腹泻停止时间（2.6±1.4）d和平均住院时间（7.3±3.9）d,均显著优于对照组的（4.3±2.1）d和（11.1±4.2）d（均P〈0.05）.结论 双歧杆菌、嗜酸乳杆菌、肠球菌三联活菌散剂是安全有效的治疗婴幼儿抗生素相关性腹泻的手段.     

脐血胆红素预测新生儿病理性黄疸的价值

目的 探讨脐血胆红素水平预测足月健康新生儿病理性黄疸程度的价值.方法 采集足月新生儿2 ml脐静脉血,用氧化法测定胆红素.生后至出院每日上午8:00-9:00,采用经皮胆红素测量仪于新生儿前额部测定胆红素.比较不同脐血胆红素范围的新生儿病理性黄疸及治疗的比例.结果 257例新生儿中59例(22.96%)发生病理性黄疸,发生病理性黄疸脐血胆红素浓度[(39.68±8.10)μmol/L]显著高于未发生病理性黄疸脐血胆红素浓度[(30.05±5.51)μmol/L](P＜0.01).随着脐血胆红索浓度上升,高胆红素血症发生率增加(P＜0.01),需干预治疗的病例增多(P＜0.01).结论 脐血胆红素水平对预测新生儿病理性黄疸有极大价值,并为早期诊断和治疗提供可靠依据.

Abstract：

Objective To investigate the predictive value of umbilical cord blood bilirubin for pathological jaundice in healthy term newborns. Methods Two ml navel string vein blood of baby were collected after giving birth in the normal newborn, and the hemobilirubin was detected by accidentally oxidation method. After birth, the infant's bilirubin level was tested on the forehead by the transcutaneous bilirubinometer at 8:00 -9:00 every morning until discharging from hospital. The ration of pathological jaundice of newborn and its treatment were analyzed in different levels of cord blood hemobilirubin. Results Fifty-nine cases ( 22.96% ) with pathological jaundice were diagnosed in 257 newboms.The concentration of cord blood hemobilirubin in baby with pathological jaundice [(39.68 ±8.10) μmol/L] was significantly higher than that of the normal newborn [(30.05 ±5.51) μmol/L](P＜0.01). As the concentration of cord blood hemobilirubin was increased, the incidence of pathological jaundice was raised (P＜ 0.01), and the cases that needed to intervention treatment was increased(P＜ 0.01). Conclusion The detection of the level of cord blood hemobilirubin is not only very worthy to estimate the occurrence of pathological jaundice of newborn, but also offer reliable evidence for clinical early diagnosis and treatment.     

沙美特罗联合替卡松粉治疗咳嗽变异型哮喘临床效果分析

目的:观察沙美特罗联合替卡松粉治疗咳嗽变异型哮喘的临床效果。方法:入选的66例咳嗽变异型哮喘按住院号随机分为2组,治疗组36例应用沙美特罗联合替卡松粉治疗,对照组30例应用常规对症及支持治疗。结果:两组经治疗后,治疗组的总有效率明显高于对照组(P<0.05)。且治疗组的咳嗽、咳痰、喘息和肺部哮鸣音消失时间与对照组比较均明显缩短,差异有统计学意义(P<0.05)。结论:沙美特罗联合替卡松粉治疗咳嗽变异型哮喘疗效确切,可改善症状及体征,值得推广。     

新生儿高胆红素血症对心肌酶谱水平的影响及临床意义

目的 探讨高胆红素对心肌的损伤作用.方法 同时测定68例高胆红素血症新生儿(研究组)与38例生理性黄疸不明显的新生儿(对照组)治疗前后的血清总胆红素(TBIL)、肌酸激酶(CK)、肌酸激酶同工酶MB(CK-MB)、心肌肌钙蛋白Ⅰ(cTnI)的水平,并进行比较.结果 研究组治疗前血清TBIL、CK、CK-MB、cTnI水平显著高于对照组[(270.24±36.89)μmol/L比(68.95±10.87)μmol/L、(414.27±135.45) U/L比(178.35±59.62) U/L、(63.31±23.25) U/L比(16.78±8.89) U/L、(0.39±0.11) μg/L比(0.18±0.07) μgL],差异有统计学意义(P＜0.05).研究组治疗后血清TBIL、CK、CK-MB、cTnI水平明显降低[(69.13±9.98)μmol/L、(183.35±61.01) U/L、(17.45±9.08) U/L、(0.19±0.01)μg/L],与治疗前比较差异有统计学意义(P＜0.05),与对照组比较差异无统计学意义(P＞0.05).结论 高胆红素导致的心肌损伤具有可逆性.应常规对高胆红素血症新生儿的心肌酶谱与肌钙蛋白进行检测,以指导临床医生对心肌的保护性治疗.     

布地奈德混悬液联合特布他林雾化液吸入治疗咳嗽变异性哮喘82例

目的探讨布地奈德混悬液联合特布他林雾化液吸入治疗咳嗽变异性哮喘的临床疗效。方法将82例咳嗽变异性哮喘患儿随机分成治疗组42例与对照组40例，对照组给予布地奈德混悬液雾化吸入治疗，其中6岁以下0.5mg/次，6岁以上1mg/次，每日2次。治疗组在对照组的基础上再给予特布他林雾化液联合吸入治疗，体重20kg以下2.5mg/次，20kg以上5mg/次，每日2次。观察两组的疗效及不良反应。结果总有效率：治疗组95.24%，对照组的75.00%，两组比较差异有统计学意义（χ2=6.72，P〈0.01）。显效率：治疗组83.33%，对照组的60.00%，两组比较差异有统计学意义（χ2=5.53，P〈0.05）。结论布地奈德混悬液联合特布他林雾化液吸入治疗咳嗽变异性哮喘疗效满意。