西咪替丁、更昔洛韦及利巴韦林治疗小儿水痘的疗效比较

目的:比较西咪替丁、更昔洛韦及利巴韦林治疗小儿水痘的疗效及安全性.方法:90例水痘患儿随机分为三组,利巴韦林组30例用利巴韦林注射液10 mg/(kg·d);更昔洛韦组30例用更昔洛韦注射液5 mg/(kg·d);西咪替丁组30例用西咪替丁注射液15 mg/(kg·d),三组均1次/d静脉滴注,疗程5 d,其他治疗相同.结果:西咪替丁组总有效率86.67%,更昔洛韦组总有效率93.33%,利巴韦林组总有效率63.33%;西咪替丁组和更昔洛韦组症状、体征好转时间比较差异无统计学意义(P＞0.05),与利巴韦林组比较差异有统计学意义(P＜0.05或P＜0.01).结论:西咪替丁和更昔洛韦治疗小儿水痘疗效显著,短期使用安全性好.     

更昔洛韦联合西米替丁治疗婴幼儿轮状病毒肠炎疗效观察

目的:探讨更昔洛韦联合西米替丁治疗婴幼儿轮状病毒肠炎的疗效。方法:将112例轮状病毒性肠炎患儿随机分为更昔洛韦组、更昔洛韦+西米替丁组和对照组三组。结果:治疗72h总有效率对照组、更昔洛韦组、更昔洛韦+西米替丁组分别为57.5%、87.5%、90.0%,更昔洛韦组、更昔洛韦+西米替丁组明显高于对照组(P<0.05或P<0.01);更昔洛韦+西米替丁组总有效率与更昔洛韦组比较差异无显著性意义(P>0.05),但显效率明显高于更昔洛韦组(P<0.05)。结论:更昔洛韦与西米替丁联合治疗婴幼儿轮状病毒肠炎疗效较好,值得临床应用。     

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.     

咪达唑仑滴鼻治疗热性惊厥的疗效观察

目的 探讨咪达唑仑滴鼻治疗婴幼儿热性惊厥的临床疗效和安全性.方法 将2010年8月-2011年3月苍南县第二人民医院急诊治疗的60例婴幼儿热性惊厥随机分为咪达唑仑组(31例)和安定组(29例).咪达唑仑组给予咪达唑仑(0.2mg/kg)滴鼻治疗,安定组予静脉注射安定(0.3 mg/kg).观察疗效和不良反应.结果 咪达唑仑组有效26例,有效率83.87%;安定组有效27例,有效率93.1%.2组比较差异无统计学意义(P＞0.05).咪达唑仑组惊厥控制时间为1~8min,平均(3.2±2.0)min;安定组惊厥控制时间为1～6min,平均(2.5±1.9)min,2组比较差异无统计学意义(P＞0.05).2组在惊厥控制总用时比较差异无统计学意义(P＞0.05).咪达唑仑组未发现明显不良反应,安定组1例患儿在用药后出现呼吸抑制.结论 咪达唑仑滴鼻治疗可有效控制婴幼儿热性惊厥,与静脉注射安定疗效相当,且更安全便捷.     

布地奈德吸入联合西咪替丁治疗毛细支气管炎临床评价

目的：评价布地奈德吸入联合西咪替丁治疗毛细支气管炎的疗效及安全性。方法：将150例毛细支气管炎惠儿随机分为对照组、治疗A组和治疗B组，分别在采用综合治疗的基础上，加用布地奈德混悬液吸入或布地奈德混悬液吸入联合西咪替丁。结果：总有效率治疗B组与A组和对照组比较差异均有显著性（P〈0．05或P〈0．01）；喘憋消失、气促缓解、哮呜音消失、湿哆音消失及平均住院时间治疗B组与A组和对照组比较明显缩短，差异均有显著性（P〈0．05或P〈0．01）。结论：布地奈德混悬液吸入联合西咪替丁治疗毛细支气管炎能增强疗效，缓解症状，缩短病程，提高治愈率，安全、有效、简便。     

血小板参数变化与新生儿缺氧缺血性脑病关系探讨

目的:探讨血小板参数的动态变化与新生儿缺氧缺血性脑病(HIE)病情程度的关系。方法:对确诊为HIE的68例患儿进行临床分度,观察患儿急性期及恢复期血小板数(PLT)、平均血小板体积(MPV)及血小板分布宽度(PDW)的变化,并与50例正常足月新生儿作对照。结果:HIE患儿急性期PLT明显降低,MPV及PDW明显升高,与对照组比较差异有显著性意义(P<0.01),HIE恢复期PLT、MPV及PDW与对照组比较差异无显著性意义(P>0.05),HIE患儿PLT随HIE病情加重而降低,而MPV、PDW则随病情加重而增大,组间比较差异有显著性意义(P<0.01)。结论:临床动态观察HIE患儿的血小板参数,可作为判断HIE的严重程度及监测病情变化的指标之一。     

纳洛酮联合多巴胺治疗新生儿缺氧缺血性脑病疗效观察

目的探讨纳洛酮联合多巴胺治疗新生儿缺氧缺血性脑病的临床疗效。方法将72例缺氧缺血性脑病患儿随机分为2组:对照组给予对症及支持等常规治疗,治疗组在此基础上给予纳洛酮0.1 mg/(kg.d)输液泵维持24 h静脉滴注,连用7 d,同时加用多巴胺5μg/(kg.min),输液泵维持24 h静脉滴注,连用7 d。观察2组患儿意识恢复时间、反射恢复时间、肌张力恢复时间和不良反应。结果意识恢复时间、反射恢复时间、肌张力恢复时间治疗组较对照组明显缩短(P<0.01)。治疗组总有效率86%、显效率41.67%,对照组总有效率61%、显效率17%,2组比较均有显著性差异(P<0.05)。结论纳洛酮联合多巴胺治疗新生儿缺氧缺血性脑病疗效满意。     

1,6-二磷酸果糖联合参麦注射液治疗新生儿缺氧缺血性脑病合并心肌损害临床研究

目的：观察1，6-二磷酸果搪（FDP）联合参麦注射液治疗新生儿缺氧缺血性脑病（HIE）合并心肌损害的疗效。方法：63例HIE合并心肌损害的患儿随机分为治疗组33例，对照组30例，两组常规治疗相同，对照组加用复方丹参注射液，治疗组加用FDP和参麦注射液。结果：治疗组在心电图恢复、心肌酶谱恢复、临床症状改善时间以及治疗第5、10天NBNA评分与对照组比较，差异有统计学意义（P〈0．05或P〈0．01）。结论：FDP联合参麦注射液治疗HIE合并心肌损害疗效显著，值得临床推广。     

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.     

国产及进口肺表面活性物质治疗新生儿呼吸窘迫综合征的疗效比较

目的:观察国产及进口肺表面活性物质(pul monary surfactant,PS)治疗新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)的疗效。方法:将54例NRDS患儿随机分为珂立苏组(28例)和固尔舒组(26例),两组在常规治疗的同时,分别给予珂立苏与固尔舒气管内滴注观察两组的疗效。结果:用药前两组患儿均有严重低氧血症,用药后30 min两组患儿动脉-肺泡氧分压比值(a/APO2)和PaO2/Fi O2明显上升,换气功能改善,用药72 min后呼吸机参数下调。两种药物都可明显缩短机械通气的时间。结论:国产及进口PS治疗NRDS疗效相当,无明显差异。