大剂量甲泼尼龙联合丙种球蛋白治疗小儿重症病毒性脑炎的临床应用

目的 探讨大剂量甲泼尼龙联合丙种球蛋白治疗小儿重症病毒性脑炎的效果.方法 将68例重症病毒性脑炎患儿随机分为治疗组和对照组,各34例.两组均给予常规治疗,治疗组在此基础上给予甲泼尼龙琥珀酸钠针15～20 mg/(kg·d)加入5％葡萄糖注射液稀释后静脉滴注,每日分2次使用,每12小时1次,连用3d后减量为2 mg/(kg·d),再用2～3d停药,同时静脉滴注丙种球蛋白0.4g/(kg·d),每日1次,连用3～5d.对照组在常规治疗的基础上静注地塞米松磷酸钠注射液0.3～0.5 mg/(kg·d),每日1次,连用5d.结果 治疗组退热、抽搐缓解、神志转清、肢体瘫痪消失时间及平均住院天数明显低于对照组(P＜ 0.01);治疗组总有效率为94.1％,对照组为73.5％,治疗组疗效明显高于对照组(P＜0.05).结论 大剂量甲泼尼龙联合丙种球蛋白治疗小儿重症病毒性脑炎可缩短病程,提高治愈率,减少并发症,疗效显著,值得临床进一步推广.

A large dose of methylprednisolone in combination of gamma globulin for children with severe viral encephalitis

Objeetive To explore the effect of a large dose of methylprednisolone in the combination of gamma globulin for children with severe viral encephalitis.Methods 68 children with severe viral encephalitis were randomly divided into a treatment group and a control group,34 cases for each group.Both groups were conventionally treated;in addition,the treatment group were intravenously dripped prednisolone sodium succinate injection diluted with 5％ glucose injection,15-20 mg/(kg·d),twice a day,once every 12 hours,for 3 days,then 2 mg/(kg·d),and stopped using this drug for 2-3 days and intravenously dripped gamma globulin 0.4 g/(kg·d),1 times a day,for 3-5 days;the control group were intravenously injected dexamethasone sodium phosphate injection 0.3-0.5 mg/(kg·d),once a day,for 5 days.Results The times for fever alleviation,convulsion alleviation,consciousness recovery,and limb paralysis disappearance and average hospital stay were significantly lower in the treatment group than in the control group (P＜0.01).The total effective rate was 94.1％ in the treatment group and 73.5％ in the control group (P＜0.05).Conclusion A large dose of methylprednisolone in the combination of gamma globulin for children with severe viral encephalitis can shorten the disease course,improve the cured rate,and reduce the complications;it is curatively effective and worth being clinically generalized.