盐酸纳美芬治疗儿童重症手足口病的效果(1)
[摘要] 目的 探讨盐酸纳美芬治疗重症儿童手足口病中的临床效果。 方法 选取本院2013年3～7月收治的220例重症手足口病患儿作为研究对象，随机分为观察组(112例)和对照组(108例)。对照组给予常规喜炎平抗病毒、脱水降颅压、控制液体入量等对症治疗，观察组在对照组的基础上给予盐酸纳美芬。比较两组的急性期症状改善时间、影像学结果及住院时间，观察两组治疗过程中有无过敏、腹泻等不良反应。 结果 观察组的总有效率显著高于对照组，差异有统计学意义(P<0.05)。观察组的体温控制、呼吸改善、易惊消失、呕吐缓解、意识障碍恢复时间及住院时间显著短于对照组，差异有统计学意义(P<0.01)。观察组的影像学异常发生率显著低于对照组，差异有统计学意义(P<0.05)。两组治疗过程中均未发生药物性皮疹、过敏性休克、腹泻等严重不良反应。 结论 盐酸纳美芬治疗儿童重症手足口病效果显著，可以明显改善患儿的临床症状，缩短住院时间，值得临床推广应用。
[关键词] 纳美芬；儿童；重症手足口病；效果
[中图分类号] R725.1 [文献标识码] A [文章编号] 1674-4721(2015)09(a)-0090-03
[Abstract] Objective To explore the clinical efficacy of nalmefene hydrochloride in the treatment of children with severe hand-foot-mouth disease (HFMD). Methods 220 children with severe HFMD from March to July 2013 in our hospital were selected and randomly divided into the observation group (n=112) and the treatment group (n=108).The control group was given symptomatic treatments such as Xiyanping for antivirus，dehydration for reducing the intracranial pressure，and controlling fluid intake，the observation group was given nalmefene hydrochloride on the basis of the control group.The time of symptoms improvement at acute stage，imaging outcomes，and hospital stay in two groups was compared.The adverse reactions including allergy and diarrhea was observed in the process of treatment. Results The total effective rate in the observation group was higher than that in the control group，with significant difference(P<0.05).The time of temperature control，improvement of breathing，disappearance of shiver with terror，remission of vomiting， consciousness recovery and hospital stay in the treatment group was shorter than that in the control group，with significant difference(P<0.01).The incidence rateof imaging abnormalities in the observation group was lower than that in the control group，with significant difference(P<0.05).There was no severe adverse reaction like drug-induced rash，anaphylactic shock，or diarrhea occurred in two groups during treatment. Conclusion The effect of nalmefene hydrochloride in the treatment of children with severe HFMD is significant，which can improve clinical manifestations and shorten hospital stay，it is worthy of clinical promotion and application.
[Key words] Nalmefene；Children；Severe hand-foot-mouth disease；Effect
儿童重症手足口病是近年来儿科常见的急危重症，以发病急、病情重、进展快为特点。致病菌以EV71、CoxA16最常见，相对而言，CoxA16引起的疾病预后较好，而EV71肠道病毒则较凶险，临床症状重，易导致严重并发症，甚至发展为多器官功能障碍综合征[1-2]，因此有效阻止重症手足口病的发展是治疗的关键。目前尚无报道有效的神经保护药物以减少重症手足口病引发的中枢神经系统并发症和后遗症[3]。本研究选取本院的重症手足口病患儿作为研究对象，在急性期给予盐酸纳美芬，取得了较为显著的效果。 (赵惠娅 郝建华 郭雯)
[关键词] 纳美芬；儿童；重症手足口病；效果
[中图分类号] R725.1 [文献标识码] A [文章编号] 1674-4721(2015)09(a)-0090-03
[Abstract] Objective To explore the clinical efficacy of nalmefene hydrochloride in the treatment of children with severe hand-foot-mouth disease (HFMD). Methods 220 children with severe HFMD from March to July 2013 in our hospital were selected and randomly divided into the observation group (n=112) and the treatment group (n=108).The control group was given symptomatic treatments such as Xiyanping for antivirus，dehydration for reducing the intracranial pressure，and controlling fluid intake，the observation group was given nalmefene hydrochloride on the basis of the control group.The time of symptoms improvement at acute stage，imaging outcomes，and hospital stay in two groups was compared.The adverse reactions including allergy and diarrhea was observed in the process of treatment. Results The total effective rate in the observation group was higher than that in the control group，with significant difference(P<0.05).The time of temperature control，improvement of breathing，disappearance of shiver with terror，remission of vomiting， consciousness recovery and hospital stay in the treatment group was shorter than that in the control group，with significant difference(P<0.01).The incidence rateof imaging abnormalities in the observation group was lower than that in the control group，with significant difference(P<0.05).There was no severe adverse reaction like drug-induced rash，anaphylactic shock，or diarrhea occurred in two groups during treatment. Conclusion The effect of nalmefene hydrochloride in the treatment of children with severe HFMD is significant，which can improve clinical manifestations and shorten hospital stay，it is worthy of clinical promotion and application.
[Key words] Nalmefene；Children；Severe hand-foot-mouth disease；Effect
儿童重症手足口病是近年来儿科常见的急危重症，以发病急、病情重、进展快为特点。致病菌以EV71、CoxA16最常见，相对而言，CoxA16引起的疾病预后较好，而EV71肠道病毒则较凶险，临床症状重，易导致严重并发症，甚至发展为多器官功能障碍综合征[1-2]，因此有效阻止重症手足口病的发展是治疗的关键。目前尚无报道有效的神经保护药物以减少重症手足口病引发的中枢神经系统并发症和后遗症[3]。本研究选取本院的重症手足口病患儿作为研究对象，在急性期给予盐酸纳美芬，取得了较为显著的效果。 (赵惠娅 郝建华 郭雯)