推拿疗法治疗小儿便秘30例临床观察

便秘是指大便秘结不通,便质多坚硬干燥,数日排便1次或排便时间延长而又艰涩难于排出。小儿便秘发病率较高,给患儿带来许多危害,引起习惯性排便障碍、肛裂,影响食欲,进而影响婴幼的生长发育。小儿药依从性差,某些泻剂易产生依赖性,而采用推拿疗法治疗便秘安全,无痛,无副作用,效果好,且简单易学。自2006年以来,我们以推拿疗法治疗儿童功能性便秘30例,报道如下。1临床资料1.1一般资料30例患儿,其中男16例,女14例;年龄最小3个月,最大9岁;病程最短5d,最长1年。30例患儿均排除胃肠器质性病变引起的便秘。1.2中医辨证分型推拿治疗便秘可分为实证和…     

中医一绝——小儿推拿

小儿推拿历史悠久，是中华医药学的一绝，具有简、便、验、廉的特点，不用服药和打针，孩子容易接受。其作用原理是医生根据病情，以不同的、轻柔的推拿手法作用于人体体表的特定部位，从而调节机体的生理病理状况，达到治疗和保健的目的。小儿推拿手法是一种良性的、有序的和具有双向调节性的物理刺激，易被小儿内脏或形体感知，从而产生功效。     

推拿配合中药治疗小儿厌食60例疗效观察

目的观察推拿配合中药治疗小儿厌食的疗效。方法对60例厌食患儿采用推拿手法治疗,同时通过辨证以中药制剂配合治疗,疗程7 d,观察各证型及总体疗效。结果 60例患儿痊愈43例,好转13例,无效4例,总有效率93.33%。结论以推拿手法配合中药治疗小儿厌食行之有效,且患儿家长易于接受。     

尼莫地平治疗小儿偏头痛临床观察

我们 1997年以来应用钙离子通道拮抗剂尼莫地平治疗小儿偏头痛 ,取得较好疗效 ,现报告如下。资料与方法一、临床资料　本组 72例小儿偏头痛为我院 1997年 3月～ 2 0 0 0年 11月门诊患儿。诊断均符合国际头痛学会(ＩＨＳ)头痛分类委员会 1988年制定的偏头痛诊断标准。随机分为治疗组 38例 ,男 13例 ,女 2 5例 ,年龄 5～ 14ａ ,平均10 .2ａ。病程 8个月～ 3ａ,平均 1.6ａ。轻度头痛 11例 ,中度18例 ,重度 9例。头痛发作频率 1～ 4次 /月 ,平均 1.5次 /月。头痛发作持续时间 5ｈ～ 3ｄ ,平均 1.8ｄ。对照组 34例 ,男 11例 ,女 2 3例 ,年龄 5～ …     

病毒灵治疗小儿手足口病临床观察

小儿手足口病是以手足出现斑丘疹和皮疹，口腔黏膜出现充血红色疹、疱疹或溃疡为主要特征的小儿急性传染病，现将我院收治的病例报告如下。[第一段]     

平喘药治疗小儿慢性咳嗽的临床观察

咳嗽是儿科临床一种常见症状,有时虽经多种抗菌药物和镇咳药治疗,但咳嗽久治不愈。为此,作者对咳嗽持续1个月以上的患儿,单用平喘药治疗,现将治疗有效的31例报道于下。 临床资料 一、一般资料 31例中男18例,女13例。年龄1 6/12岁～5例,3岁～14例,7岁以上12例。病程1个月以上17例,2个月以上6例。3个月以上5例,5个月以上3例。咳嗽多呈发作性,常于夜间或清晨发作,白天无咳嗽或偶有轻咳。活动或大笑后咳嗽加剧者8例,喉头发痒5例。胸闷3例,14例咳少量白色痰,17例无痰。病程中均无发热。全部病例均经3种以上抗生素和多种止咳药较长期治疗无效。     

推拿疗法治疗小儿肌性斜颈32例疗效观察

目的观察推拿治疗小儿肌性斜颈的临床疗效。方法选取32例门诊肌性斜颈患儿,采用推拿治疗,观察治疗前后临床症状的变化。结果 32例肌性斜颈患儿,痊愈25例(78.13%),好转7例(21.87%),总有效率100%。结论推拿治疗能明显改善小儿肌性斜颈的临床症状,值得推广使用。     

夜醒与婴幼儿认知发育的相关性研究

目的了解影响婴幼儿夜醒的环境因素,探讨婴幼儿夜醒与认知发育的相关性。方法随机抽取2011年12月-2013年2月义乌市城区和乡镇各1个点作为项目点,共抽取2~30个月婴幼儿116名。以问卷形式对儿童及其家长进行调查,了解儿童出生及家庭社会经济的相关情况;采用简易婴儿睡眠问卷(BISQ)收集儿童夜醒次数及时间等相关睡眠情况;同时采用Bayley婴幼儿发育量表进行婴幼儿认知发育评估。结果调查对象平均年龄为(12.99±8.55)月(2~30个月),男孩占50.86%(59/116)。1岁婴儿,偶尔夜醒仅占5.26%,夜醒1次占29.82%,夜醒多次占64.91%;≥1岁幼儿则分别为32.20%、45.76%和22.03%。1岁婴儿和≥1岁幼儿夜醒次数的分布差异有统计学意义(P0.01)。1岁婴儿平均夜醒时间为(0.49±0.31)h,≥1岁幼儿为(0.31±0.48)h,差异有统计学意义(Z=4.35,P0.001)。≥1岁幼儿随着夜醒次数增加,智力发育指数(MDI)下降,差异有统计学意义(F=3.98,P=0.024);夜醒时间与MDI呈显著负相关(r=-0.26,P=0.035)。1岁婴儿的夜醒次数和夜醒时间与MDI无相关性。多元线性回归分析证实夜醒次数及时间是≥1岁幼儿MDI的独立影响因素。结论对持续夜醒婴幼儿应引起高度关注。     

中西医结合治疗小儿厌食症临床观察

小儿厌食症是儿科常见病，以往单纯用西药治疗取得一定疗效，但有些患儿疗效不理想。2004～2006年我科对儿科门诊厌食症患儿82例采用了中西药结合治疗，取得满意疗效，现报告如下。     

炎琥宁治疗小儿上呼吸道感染临床疗效观察

目的 观察炎琥宁治疗小儿上呼吸道感染的疗效.方法 将107例患儿随机分为两组,对照组(69例)给与炎琥宁静滴,对照组(38例)给与病毒唑静滴,观察疗效并进行统计学处理.结果 治疗组疗效优于对照组,有显著性差异(P＜0.05).结论 炎琥宁治疗小儿上呼吸道感染效果好,值得临床应用.     

Comforters and night waking.

Among 320 low birthweight infants seen at nine months post term those using a soft object, thumb, or fingers as comforter were significantly less likely to wake at night (9/96, 9%) than those with no comforter or using a dummy (66/224, 29%). Dummy users were as likely to wake (27/93, 29%) as those without a comforter (39/131, 30%).     

Controlled trial of trimeprazine tartrate for night waking.

Mild hypnotics are often recommended for young children with sleep problems. This study assesses the efficacy of trimeprazine tartrate in 1 to 3 year old children with persistent and severe night waking in a double blind crossover trial with placebo. Children on treatment with trimeprazine had significantly fewer wakings, less time awake at night, and more night time sleep compared with those on treatment with placebo. There were no differences in these sleep variables when the first and last (fourth) week of treatment with drugs were compared. Follow up observations showed no significant difference in any sleep variables from baseline measures. The results are consistent with the idea that trimeprazine tartrate may be a useful short term treatment for night waking in young children.     

Efficacy of prednisolone in children hospitalized for recurrent wheezing

Data on the efficacy of corticosteroids on respiratory picornavirus-induced wheezing are limited. To determine whether prednisolone is effective in rhinovirus- or enterovirus-induced recurrent wheezing, we conducted a controlled trial comparing oral prednisolone (2 mg/kg/day in three divided doses for 3 days) with placebo in hospitalized wheezing children and studied post hoc virus-specific efficacy in early wheezing (<3 episodes, reported elsewhere) and in recurrent wheezing (>or=3 episodes). Virus-negative children where excluded. Our primary endpoint was the time until children were ready for discharge. Secondary endpoints included oxygen saturation and exhaled nitric oxide during hospitalization, duration of symptoms, blood eosinophil count, and impulse oscillometry 2 wk after discharge, and occurrence of relapses during the following 2 months. Virus-specific effects were analyzed with interaction analysis in a multivariate regression model. During the study period, 661 patients were hospitalized, 293 randomized, and 59 were accepted in this analysis (mean age 2.6 yr, s.d. 1.3). Prednisolone did not significantly decrease the time until ready for discharge in all patients (prednisolone vs. placebo, medians, 18 vs. 24 h, p = 0.11). However, prednisolone decreased the time until ready for discharge in children with picornavirus infection (respectively, 12 vs. 24 h, p = 0.0022) and more specifically, in children with enterovirus infection (6 vs. 35 h, p = 0.0007). In the secondary endpoints, prednisolone decreased the duration of cough and dyspnea in rhinovirus-affected children (p = 0.033 for both). Prospectively designed clinical trial is needed to test the hypothesis that prednisolone reduces symptoms in picornavirus-affected wheezing children.     

Efficacy of bleomycin treatment for symptomatic hemangiomas in children

Five children aged 5–19 years had pain in massive, inoperable hemangiomas. They were treated with intralesional injections of 2 mg bleomycin as a 0.4 mg/ml solution in the painful area. The injections were repeated after 4-6 weeks for a total of 6–10 times. All children were relieved of pain, and the swelling was reduced in all cases. There were no complications or side effects. Bleomycin therapy of painful, massive hemangiomas can be recommended in older children.     

以夜间惊醒为主要症状的川崎病并巨大冠状动脉瘤1例报告

患儿,男,9岁,因反复出现夜间惊醒3个月,加重1个月入院。夜间惊醒表现为入睡后突然惊醒,自觉“心跳快”,伴有心慌、恐惧感,数分钟后入睡,每夜3~4次,近1个月较前频繁。病程中无发热,白天精神不振,无其他不适症状,下肢皮疹5~6年。患儿平素身体健康,无心脏病家族史。体查：T 36.8℃,P 80次/min,R 24次/min,BP 98/66 mm Hg,神志清,精神可,浅表淋巴结未触及肿大,掌跖无红斑及硬肿,眼结膜无充血,口唇无充血及杨梅舌改变,心前区无隆起,心界正常,心率80次/min,心律不齐,心音有力,未闻及杂音,双下肢可见陈旧性紫癜样皮疹,肺、腹、神经系统及四肢体查无异常。心脏彩超示：短轴缩短率（FS）：34%,射血分数（EF）：64%,左右冠状动脉起始位置正常,左冠状动脉内经3.1 mm,右冠状动脉瘤样增宽,走形迂曲,扩张不均匀,起始处内径12.3 mm,远端较宽处内径21 mm,较窄处内径8 mm,较宽处凸向右室,右室流出道及流入道无明显狭窄,未见破口。超声提示：右冠状动脉瘤（图1）。24 h动态心电图示窦性心律不齐,不完全性右束支阻滞,心率变异性增高。胸片示：双肺纹理增强。血常规示：WBC 5.03×109/L, NE%0.42,LY%0.49,MO%0.06,RBC 4.30×1012/L, HGB 120 g/L,PLT 143×109/L;肌酸肌酶、肌酸激酶同工酶均正常;凝血常规、肝肾功能、血沉均正常;超敏C反应蛋白0.86 mg/L（正常范围0~3 mg/L）,B型钠尿肽前体123.0 pg/mL（正常范围0~125 pg/mL）。详细追问病史,其父亲回忆患儿约3岁时曾高热,持续约1周,全身皮疹,给予抗感染治疗,症状好转,故考虑临床诊断：川崎病（KD）,右冠状动脉瘤。治疗上给予丙种球蛋白（每日1 g/kg）静脉滴注2 d,营养心肌治疗,并口服阿司匹林片（每日5 mg/kg）及双嘧达莫片（每日3 mg/kg）。1周后转入上一级医院,冠状动脉造影（CAG）示：左前降支（LAD）轻度心肌桥,右冠状动脉瘤（近端）（分叶状）。冠状动脉CT血管成像（CTA）示：右侧冠状动脉近、中段冠状动脉瘤形成,累及右冠状动脉出口至远端,冠LAD及回旋支（LCX）未见明显狭窄或瘤样扩张改变（图2）。体外循环下行冠状动脉成形术,术中探查：右冠状动脉近端局部形成动脉瘤（50 mm×30 mm×20 mm）,瘤径约20 mm,瘤体浸入右室游离壁心肌内。术后给予抗感染、抗凝、营养心肌治疗。术后夜间惊醒症状消失,出院后继续按原剂量口服阿司匹林及双嘧达莫,出院后1个月复查心脏彩超示：FS：33%,EF：64%。冠状动脉成形术后,右冠状动脉起始部内径6.3 mm,距起始部约7 mm处,可见管状血管强回声影,宽2.9 mm;左冠状动脉内径3.3 mm （图3）。随访2个月,现患儿学习生活正常。     

Chronic night cough and asthma severity in children with stable asthma

The relationship between night cough and other indices of asthma severity was studied in 21 children with clinically stable asthma and persistent night cough. Overnight cough was quantified and related to symptom scores, oxygen saturation (S_aO₂) during sleep, evening and morning peak flow recordings and daytime tests of lung function. In the index group the median number of coughing episodes was 23 (range 1–158). Only 4 children had counts of <10 overnight, similar to the comparison group of 12 children all of whom had counts of <10. There was a trend towards the association of overnight cough with reduced evening peak flow (r=–0.407,P=0.07) and reduced S_aO₂ (r=–0.36,P=0.10). Abnormalities in daytime tests of lung function were observed in 13 children. There was no relationship between night cough and daytime indices of lung function abnormality although children with more severe daytime abnormalities also had significant night cough. Conversely, five children with chronic night cough had normal daytime function.Conclusion Night-time cough in children with asthma is not simply a reflection of daytime lung function status, whereas, overnight S_aO₂ correlates well. Other factors need to be explored to explain the variability of night-time cough in these children.     

First night effect for polysomnographic data in children and adolescents with suspected sleep disordered breathing

Aims

To assess the presence of a first night effect (FNE) in children and adolescents and to examine if a single night polysomnography (PSG) is sufficient for diagnosing obstructive sleep apnoea syndrome (OSAS).

Methods

Prospective case study of 70 patients (group 1: 2–6 years, n = 22; group 2: 7–12 years, n = 32; group 3: 13–17 years, n = 16) referred for OSAS. Diagnostic criteria for OSAS: one or more of the following: (1) obstructive apnoea index (OAI) ⩾1; (2) obstructive apnoea hypopnoea index (oAHI) ⩾2; (3) SaO₂ ⩽89% in association with obstruction.

Results

In all age groups, but mainly in the oldest children, REMS increased during the second night, mainly at the expense of stage 2 sleep. The first night PSG correctly identified OSAS in 86%, 91%, and 100% of the children for groups 1, 2, and 3 respectively. This represents 9% false negatives for OSAS when only the first night PSG was used. All cases missed had mild OSAS, except for one with oAHI >5 on night 2. There were also seven patients with OSAS on night 1 but with a normal PSG on night 2: all had oAHI <5.

Conclusion

There is a FNE in children and adolescents. A single night PSG is sufficient for diagnosing OSAS, but in cases with a suggestive history and examination and with a negative first night, a second night study might be advisable.