头孢克洛治疗婴幼儿下呼吸道感染

目的观察头孢克洛治疗下呼吸道细菌感染的疗效及安全性。方法观察组予头孢克洛20mg/(kg·d)口服,3次/d。对照组静脉滴注第3代β内酰胺类抗生素(头孢哌酮或头孢曲松)50～80mg/(kg·d),2次/d。两组疗程均为7d。结果观察组临床总有效率为92.5%,不良反应率为5.55%;对照组总有效率94.23%,不良反应发生率13.4%。两组疗效比较无明显差异(P>0.05)。结论口服头孢克洛治疗婴幼儿下呼吸道感染有效、安全。     

环酯红霉素干混悬剂治疗儿童急性呼吸道感染的疗效

目的评价环酯红霉素干混悬剂对小儿急性呼吸道感染的疗效及不良反应。方法将急性呼吸道感染患儿63例随机分为A组(29例)和B组(34例)。A组予环酯红霉素干混悬剂口服,每次15 mg·kg-1,2次·d-1。B组予阿奇霉素干混悬剂口服,每次10 mg·kg-1,1次·d-1。对2组患儿的发热时间、临床表现进行随访观察,比较2组临床痊愈率、有效率及不良反应情况,并对结果进行统计学分析。结果 A组和B组痊愈率分别为51.72%和61.76%,2组比较差异无统计学意义(P>0.05)。A组和B组有效率分别为89.66%和88.24%,2组比较差异无统计学意义(P>0.05)。比较2组发热、咳嗽等变化,结果显示差异无统计学意义。仅A组1例患儿出现恶心、呕吐、食欲下降等胃肠道反应,但可耐受,未影响继续治疗。结论环酯红霉素干混悬剂治疗小儿急性呼吸道感染安全有效,与阿奇霉素干混悬剂的疗效无明显差异。     

阿奇霉素序贯疗法治疗肺炎支原体肺炎

目的探讨阿奇霉素序贯疗法对小儿肺炎支原体肺炎(MPP)的疗效。方法将92例MPP患儿随机分为2组:治疗组47例,对照组45例。2组患儿除均予综合治疗外,对照组静脉滴注注射用乳糖酸红霉素治疗,30 mg.kg-1.d-1,应用10～14 d;治疗组采用阿奇霉素序贯疗法治疗,即静脉滴注阿奇霉素(10 mg.kg-1.d-1,应用3～5 d)后口服阿奇霉素干混悬剂(10 mg.kg-1.d-1,应用7 d)。比较2组疗效、不良反应发生情况体征消失时间以及住院时间。结果对照组总有效率为77.78%,治疗组总有效率为95.74%,治疗组疗效显著优于对照组(P<0.05)。治疗组不良反应发生率为21.28%,对照组不良反应发生率为55.56%,治疗组不良反应的发生率显著低于对照组(P<0.05);治疗组体征消失时间和住院时间均显著少于对照组(Pa<0.05)。结论采用阿奇霉素序贯疗法治疗小儿MPP的效果显著。     

肺炎支原体肺炎不同药物治疗的疗效观察及随访

目的：探讨肺炎支原体肺炎最佳治疗药物及随访情况。方法：15 9例肺炎支原体肺炎分别给予红霉素静脉滴注(静脉组)和阿奇霉素口服(口服组)治疗,比较疗效并随访。结果：静脉组2周内痊愈63例(72.4%),口服组2周内痊愈37例(51.4%),两组差异有显著性, P<0.05。1年后随访的157例患儿有44例(28.0%)出现反复呼吸道感染,静脉组占25例(28.7%),口服组占19例(27.1%),两组差异无显著性。病程≥4周的40例患儿中17例(42.5%)有反复呼吸道感染,而病程<4周的117例中仅27例(23.1%)有反复呼吸道感染,两组差异有显著性,P<0.05。结论：肺炎支原体肺炎静脉滴注红霉素的近期疗效优于阿奇霉素口服。部分患儿肺炎支原体肺炎痊愈后1年随访出现反复呼吸道感染,与初始治疗前的病程长短有关。     

门冬氨酸阿奇霉素与红霉素治疗儿童支原体肺炎的对照研究

目的比较门冬氨酸阿奇霉素与红霉素治疗儿童支原体肺炎的疗效和不良反应。方法符合诊断标准的支原体肺炎患儿80例。用抽签法分为两组,40例采用门冬氨酸阿奇霉素10 mg/(kg.d)静脉滴入,连用3 d,停3 d,再用3 d;40例采用乳糖酸红霉素30 mg/(kg.d),分2次,Q12 h静脉滴入,连用14 d。用专用表格记录患儿治疗前的病情和在疗程中逐日观察记录症状、体征的变化及不良反应,并于治疗前后做有关的实验室检查和拍X线胸片,按疗效判断标准比较两组的疗效和不良反应。结果门冬氨酸阿奇霉素组的痊愈率(90%)明显高于红霉素组(56.8%),χ2=3.85,P<0.05;症状、体征消失较快(P均<0.05);而不良反应明显较少,χ2=12.58,P<0.01。结论门冬氨酸阿奇霉素治疗儿童支原体肺炎疗效好,疗程短,用法简便,不良反应少,值得推广。     

阿奇霉素治疗婴幼儿支原体肺炎30例疗效观察

目的探讨阿奇霉素治疗婴幼儿支原体(MP)肺炎的疗效。方法将2006年8月-2008年8月收治的60例婴幼儿MP肺炎患儿随机分为治疗组和对照组各30例。治疗组应用阿奇霉素10mg/(kg·d)静脉滴注,1次/d,3～5d为1个疗程;对照组应用红霉素20～30mg/(kg·d)静脉滴注,2次/d,7～10d为1个疗程。观察2组退热时间,咳嗽、喘息消失时间,肺部啰音消失时间,住院天数及不良反应发生情况。结果治疗组显效24例(80%),有效5例(17%),无效1例(3%);对照组显效17例(57%),有效12例(40%),无效1例(3%)。两组显效率比较有显著性差异(χ2=13.45P<0.05),总有效率比较无显著性差异(χ2=0.56P>0.05)。治疗组在体温恢复退热时间,咳嗽、喘息消失时间,肺部湿哕音消失时间,住院天数等均较对照组短(Pa<0.05)。治疗组不良反应发生率为10%,对照组为27%,两组比较有显著性差异(χ2=17.43P<0.05)。结论阿奇霉素治疗可迅速改善MP肺炎婴幼儿的症状和体征,缩短住院天数,同时不良反应少而轻微,用药依从性好,其临床疗效及安全性值得信赖,值得临床推广。     

穿心莲内酯磺化物辅助治疗肺炎支原体肺炎80例临床观察

目的观察穿心莲内酯磺化物辅助治疗肺炎支原体肺炎(MP)的临床疗效。方法将2013年1月至2015年12月河北省邢台市人民医院儿科收治的MP患儿160例,按随机数字表法分为对照组与观察组各80例。两组均采用阿奇霉素及对症治疗,观察组再辅以穿心莲内酯磺化物治疗,比较两组治疗后总有效率及免疫指标,比较难治性MP和不良反应的发生率。结果观察组患儿治疗总有效率为91.25%,对照组为73.75%;此外,观察组肺部啰音消失时间(9.12±2.36)d,咳嗽消失时间(8.13±2.13)d,退热时间(4.36±2.21)d,住院时间(13.34±2.52)d,均明显优于对照组的(12.51±2.13)d,(13.51±2.36)d,(7.58±2.55)d,(19.14±3.31)d;治疗后两组细胞免疫及体液免疫指标均较治疗前有改善,但观察组改善幅度优于对照组;观察组难治性MP发生率为12.5%,明显低于对照组的30%,差异有统计学意义(P0.05);两组患儿不良反应发生率比较,差异无统计学意义(P0.05)。结论穿心莲内酯磺化物用于辅助治疗MP不仅能提高MP治愈率,缩短住院日,改善免疫功能,同时也能降低难治性MP发生率。     

门冬阿奇霉素与红霉素治疗小儿支原体肺炎疗效的比较

目的比较门冬氨酸阿奇霉素与红霉素治疗小儿支原体肺炎的疗效和不良反应。方法将诊断为支原体肺炎的患儿65例随机分成2组。34例采用门冬氨酸阿奇霉素10mg/(kg.d)静脉滴注,用药5d;31例采用红霉素15~30mg/(kg.d)静脉滴注,用药7~14d。治疗后根据疗效评价比较2组疗效和不良反应。结果门冬氨酸阿奇霉素组的痊愈率(79.41%)明显高于红霉素组(48.39%)(χ2=6.82,P<0.05);不良反应明显较少(χ2=10.52,P<0.01)。结论门冬氨酸阿奇霉素治疗小儿支原体肺炎疗效好、疗程短、不良反应少,值得推广。     

阿奇霉素治疗儿童伤寒疗效观察

目的　近年来儿童伤寒耐药性明显升高,且对目前的替代剂头孢曲松和诺氟沙星的耐药菌株也有 增多的趋势,为探讨治疗儿童伤寒其它合适替代药物,该文采用阿奇霉素治疗儿童伤寒并观察其临床疗效、副作用和 耐受性。方法　45例确诊伤寒患儿,随机分为治疗组和对照组,治疗组23例,给予阿奇霉素治疗;对照组22例,给予 头孢曲松钠治疗。观察其临床疗效和副作用。结果　治疗组与对照组有效率分别为100%和90.9%,两组间差异无 显著性(P>0.05);治疗组与对照组退热时间分别为3.12±0.44d和3.18±0.53d,两组间差异无显著性(P>0.05)。 两组均未出现不良反应。结论　阿奇霉素治疗儿童伤寒具有良好疗效。     

痰热清注射液佐治小儿呼吸道感染60例

目的观察痰热清注射液佐治小儿呼吸道感染的疗效。方法将呼吸道感染的患儿118例随机分为治疗组和对照组.治疗组静注痰热清注射液0.5-10mL/(kg·d),1次/d.疗程3-7d;对照组给予鱼腥草注射液1.0-1.5mL/(kg·d),1次/d,疗程3-7d。两组均同时使用头孢他啶。结果治疗组与对照组治愈分别为34例、29例;显效分别为15例、18例;有效分别为9例、8例;无效分别为2例、3例,两组总有效率分别为96.67%、97.83%.经统计学处理无显著差异(u=0.620P=0.535)。且未发现有皮疹、寒颤、发热、点滴局部疼痛等不良反应。结论痰热清注射液佐治小儿呼吸道感染疗效确切.可与鱼腥草注射液达到同等临床疗效,为临床治疗小儿呼吸道感染提供了一种新的治疗药物。     

Update on Cochrane data on paediatric respiratory diseases

INTRODUCTION: Systematic reviews seek to describe and summarise the best evidence for a given intervention by pooling data from relevant quality clinical trials. The Cochrane Collaboration has fostered the development and dissemination of systematic reviews throughout the world. We have identified and summarised The Cochrane systematic reviews of relevance to the paediatric pulmonologist. METHODS: We performed an expert search of the Cochrane Database of Systematic Reviews using a combination of medical subject headings and free text terms relating to paediatric respiratory disease. RESULTS: The search identified 120 systematic reviews with interventions specific to children with some relevance to pulmonary disease, and 327 reviews with interventions relating to pulmonary disease in adults and children. After pragmatic exclusions, 81 reviews were sorted by disease and 59 of these are discussed in detail. CONCLUSIONS: There are now many systematic reviews that make a positive contribution to paediatric pulmonology. The majority of reviews (69%) found evidence that either confirmed or refuted an accepted practice. The remaining reviews concluded that the evidence for an accepted practice is poor and sometimes wholly absent. Clinicians must be aware that lack of evidence of effect is not the same as evidence of lack of effect. Caution must be exercised before applying the conclusions of systematic reviews based upon adult data to childhood disease.     

Passive smoking by asthmatics: its greater effect on boys than on girls and on older than on younger children

In 415 nonsmoking asthmatic children who were seen consecutively, asthma symptoms were more severe if the mother was a smoker than if she was a nonsmoker. This applied to both sexes but was more marked in boys than in girls. There were also other indications that sons were the more severely affected: the forced expiratory volume at 1 second, the forced expiratory flow rate during the middle half of the forced vital capacity, and the provocation concentration of histamine needed to result in a 20% decrease in the forced expiratory volume at 1 second were significantly decreased only in the sons, and lung function test results were significantly less in sons than in daughters of mothers who smoked. When the 415 children were stratified according to age, lung function improved significantly with increasing age in the children of nonsmokers; in children of smokers, by contrast, symptoms and lung function test results became progressively worse. As well, there was a correlation between these indications of asthma severity and the number of years the child had been exposed to the mother's smoke. It appeared that, compared with girls, boys were more sensitive to passive smoking, and that its adverse effect increased with age and with duration of exposure.