不同剂量糖皮质激素治疗小儿重症手足口病2期的疗效观察

目的探讨不同剂量静脉注射糖皮质激素治疗小儿重症手足口病2期的疗效。方法以2011年5月～7月确诊累及神经系统的手足口病重症患儿为研究对象,回顾性分析全部患儿在利巴韦林10 mg.kg-1.d-1抗病毒及对症支持治疗的基础上,加用不同剂量甲基强的松龙:大剂量组(A组)10～15 mg.kg-1.d-1;小剂量组(B组)1～2 mg.kg-1.d-1;无激素使用组(C组);比较三组临床治疗效果。结果三组患儿神经系统受累时间、住院天数差异无统计学意义(P0.05)。无激素使用组(C组)发热持续时间比激素使用组(A、B组)长,差异有统计学意义(P0.05),但A、B组间差异无统计学意义(P0.05)。三组共81例患儿均痊愈出院,治疗过程中无进展出现神经源性肺水肿、心力衰竭。结论小儿重症手足口病2期使用小剂量糖皮质激素,可使热程缩短,减轻患儿痛苦及家长焦虑情绪;但是无论大剂量或小剂量糖皮质激素都不能缩短其病程,改善预后。

Curative effect of various doses of glucocorticoid on children in phase 2 of hand-foot-mouth disease

Objective To discuss the therapeutic effect of 3 doses glucocorticoid impaction in the treatment of hand-foot-mouth disease phase 2.Methods The sick children with HFMD of neurological involvement hospitalized from May to July in 2011 were enrolled into the study.All cases received ribavirin and therapies based on their symptoms,while 33 cases received high dose methylprednisolone 10 ~15 mg·kg-1·d-1,24 cases received small methylprednisolone 1~2 mg·kg-1·d-1,and another 24 cases received no methylprednisolone.The curative effect of the three groups were investigated.Results The CNS involvement duration,time of staying in hospital in 3 groups were not significantly different（P0.05）.But the febrile duration is shorter in the non-hormone group than those of other groups,which demonstrated a significant difference（P0.05）.Eighty-one recruited cased with HFMD of neurological involvement were recovered,and no cases developed into neurogenic pulmonary edema or congestive heart failure during the treatment.Conclusion Small dose glucocorticoid can reduce the fever duration,which lightens the suffering of sick children and anxiety of parents.But glucocorticoid in the therapy of HFMD phase 2 can not shorten the course and improves prognosis.