目的 探讨并评估机械振动排痰辅助治疗儿童肺炎支原体肺炎的临床疗效.方法 将120例肺炎支原体肺炎患儿分为两组各60例,两组基本治疗相同,治疗组加用机械振动排痰仪进行机械辅助排痰,观察两组在热退时间、咳嗽、咳痰、喘息等症状消失时间,肺部啰音消失时间,肺部影像学明显改善时间,平均住院日、住院次均费用、药占比、病人满意度等方面的变化.结果 治疗组退热时间为(3.5±1.0)天,咳嗽、咳痰、喘息等临床症状消失或缓解时间为(7.5±1.1)天,肺部体征消失时间为(5.9±0.9)天,肺部影像学明显改变吸收时间为(7.0±0.8)天,住院时间为(9.9±0.8)天,与对照组相比,相应时间均缩短,有统计学意义;次均费用为(2782.2±109.4)元,药占比为(19.2±0.3)％,患者出院时的满意度为(90.6±2.9)％,上述结果与对照组比较,次均费用及药占比均下降,满意度提高,以上均有统计学意义.结论 采用机械振动排痰治疗儿童肺炎支原体肺炎疗效肯定,值得儿科医护工作者重视.

Objective:To evaluate the efficacy and safety of pharyngeal spraying recombinant human interfe-ron alpha 2b (rhIFNα2b) in the treatment of herpangina in children.Method:s A prospective, multicenter, rando-mized, opened and controlled study was carried out in 11 hospitals in Anhui province from August 2018 to March 2019.According to the time of admission, 180 patients diagnosed as herpangina were prospectively and randomly divided into rhIFNα2b treatment group and Ribavirin control group.On the basis of giving both groups the heat-clearing, detoxifying and anti-infection treatment, the patients in treatment group received pharyngeal spraying rhIFNα2b 9 g/L saline solution[1 million IU/mL, 0.1 million IU/(0.1 mL·press)], and the patients in control group were treated by pharyngeal spraying Ribavirin (0.5 mg RBV/press, 150 press), 3 presses per time, 4 times per day, continuous administration for 5 days for both groups.Those who recovered in advance were no longer given medication.All patients were observed to fully recover.The clinical efficacy and the disappearing time of symptoms and signs between two groups were compared, and the safety of pharyngeal spraying rhIFNα2b for patients was evaluated.Result:s All of the 180 patients completed the study, including 90 cases in the treatment group and 90 cases in the control group.There was no statistically significant difference in terms of gender, age, weight and course of illness before treatment between the two groups (all P>0.05), which had clinical comparability.The apparent efficiency of the treatment group [63.3% (57/90 cases)] was significantly higher than that in the control group [38.9% (35/90 cases)] and the difference was statistically significant( χ2=10.934, P=0.004); no significant difference in the total efficiency between the treatment group [96.7% (87/90 cases)]and the control group [92.2% (83/90 cases)]was observed ( χ2=2.924, P=0.169). The duration of fever[(32.59±20.73) h vs.(45.72±26.96) h], hyperemia[(76.48±23.12) h vs.(92.44±24.31) h], herpes[(72.99±25.77) h vs.(85.09± 26.62) h], salivation[(45.44±24.96) h vs.(54.42±31.20) h] and anorexia[(62.70±23.99) h vs.(78.71±30.54) h] in the treatment group were significantly shorter than those in the control group, and the differences were statistically significant(all P<0.05). Before treatment, the serum levels of tumor necrosis factor α(TNF-α) [(13.02±4.41) ng/L vs.(13.57±9.27) ng/L], interleukin-6(IL-6) [(26.48±11.31) ng/L vs.(30.15±15.55) ng/L] and C-reactive protein(CRP)[(19.34±14.11) mg/L vs.(19.83±14.57) mg/L]were not significantly different between the two groups (all P>0.05). After treatment, the serum levels of TNF-α and IL-6 were(7.26±1.99) ng/L and (2.42±0.73) ng/L in the treatment group, which were significantly lower than those in the control group [(12.09±6.39) ng/L and (7.32±11.51) ng/L](all P<0.05), but no significant difference in serum levels of CRP between the two groups was observed ( P>0.05). The comparison on positive rate of virus in pharyngeal swab between the treatment group [65.3% (32/49 cases) and 40.6% (13/32 cases) respectively] and the control group[66.7%(36/54 cases) and 41.0% (16/39 cases), respectively]before and after therapy showed no significant difference (all P>0.05). During the treatment, no serious adverse reactions were observed in the two groups.The incidence of adverse reactions was 1.1% (1/90 cases) in the treatment group and 5.6% (5/90 cases) in the control group.In addition, the serum hemoglobin level of children in the control group after treatment was significantly lower than that before treatment and that in the treatment group (all P<0.05). Conclusions:Compared with pharyngeal spraying ribavirin, pharyngeal spraying rhIFNα2b can greatly improve the clinical efficiency, accelerate the disappearance of clinical symptoms and signs, and shorten the total course of disease, and is more safe and worthy of clinical application.

目的 分析我院就诊儿童尿路感染常见病原菌的种类及各种类耐药情况,为今后选择对尿路感染菌群敏感的抗生素提供有效依据,提升尿路感染治疗的有效率.方法 采集近两年在我院临床诊断为尿路感染的患儿清洁中段尿标本203份,进行尿液常规检测及细菌培养加鉴定,并对培养出的革兰阴性菌进行产超广谱β-内酰胺酶(extended-spectrum beta-lactamase,ESBLs)检测;数据进行统计分析.结果 203份标本中检出病原菌51株,检出细菌阳性率为25.12％;在检出的51例病原菌中,大肠埃希菌为39例,占总检出菌群比为70.58％,其次粪肠球菌为4例,占总检出菌群比为7.84％;检出肺炎克雷伯菌为3例,占总检出菌群比为5.88％.共有检出16例细菌产超广谱β-内酰胺酶,占总检出菌群的31.37％,尚未检测出耐甲氧西林葡萄球菌.结论 以大肠埃希菌和肺炎克雷伯菌为主的革兰阴性菌仍是儿童尿路感染病原菌主要构成,临床应根据药敏结果合理选择抗生素.

Objective To discuss the application of family atomization inhalation therapy for children with positive asthma predictive index (PAI).Methods According to their parents’willing,126 children with positive asthma predictive index in acute attack were divided into the treatment group (n =64)and the control group (n =62).The cost,curative effect and adverse reactions were compared between the two groups.Results The cost and the adverse reactions of the treatment group were less than those of the control group,and the incidence of hospital-acquired infection and cross infection was lower in the treatment group than in the control group.Conclusion The cost and the adverse reactions of atomization treatment are obviously lower,with less hospital-acquired infection and cross infection,and it also has better curative effect.

目的 通过回顾性研究,比较普通型肺炎支原体肺炎(Mycoplasma Pneumoniae Pneumonia MPP)患儿及难治性肺炎支原体肺炎(refractory Mycoplasma pneumonia RMPP)患儿早期D-二聚体和C反应蛋白(C-reactive protein,CRP),观察RMPP患儿与普通MPP患儿,在早期D-二聚体和CRP的差别,以协助对RMPP患儿临床的早期认识.方法 回顾性收集肺炎支原体肺炎患儿115例,根据其病情及治疗的过程分为普通型MPP组63例和RMPP组52例,并设正常对照组60例.比较3组儿童中血清CRP和D-二聚体的数值.结果 RMPP组患儿的D-二聚体和CRP均较正常对照组明显升高,差异有统计学意义(P＜0.01);RMPP组患儿与普通型MPP组相比,D-二聚体明显升高,差异有统计学意义(P＜0.01),但两组CRP差异无统计学意义.结论 D-二聚体检测对RMPP患儿早期诊断有一定的指导意义.

Objective:To evaluate the staged therapeutic efficacies for management of infantile lactose intolerance secondary to the rotavirus infection . Methods:The clinical data were collected in 113 infants with lactose intolerance secondary to rotavirus infection admitted to our hospital ,and the infants were divided into different groups according to the disease severity,i.e.,severe disease(experimental group,n=31) and controls(control group,n=27);mild disease(experimental group,n=26) and controls(control group,n=29).The control group received conventional treatment by anti-infection,supple-ment of fluid and electrolyte ,oral gastrointestinal mucosal protective agent and microbial ecological agent ,whereas the experimental group were treated with additional lactase on the conventional protocol basis,and two groups were observed and compared regarding the therapeutic efficacies.Results:The effective rate was 93.55% for the experimental group of severe disease and 51.85% for the control counterparts,and the difference was significant (P<0.01), whereas 88.46% in the experimental group with mild disease and 86.21% in the corresponding controls responded well to the therapy,which showed no significant difference within groups(P>0.05).Conclusion:Treatment of the infantile lactose intolerance secondary to the rotavirus infection shall be in diverse plan.Supplement of lactose can be effective to infants with severe diarrhea ,yet conventional therapy may be effective and economical for those with mild disease.

目的观察赖氨葡锌颗粒治疗轮状病毒性肠炎55例的疗效。方法选择2010年1月～12月本院门诊及住院的轮状病毒性肠炎患儿105例,随机分为治疗组55例,对照组50例。两组在常规治疗的基础上,治疗组加用赖氨葡锌颗粒,比较两组疗效。结果治疗组和对照组总有效率分别为82.87%和70.00%,两组比较差异有统计学差异(P<0.05)。结论赖氨葡锌颗粒治疗轮状病毒性肠炎,疗效确切,口感好,值得临床推广。

Objective To investigate tile clinical effect and its safety of mucosolvan and magneisium sulphate in treatment of capillary bronchitis.Methods 40 cases of capillary bronchitis admitted from November 2004 to February 2005 were adopted as the control,and other 48 cases of capillary bronchitis admitted from November 2005 to January 2006 were adopted as the treatment group.Both received routine therapy,with exceptionthat additional mucosolvan and magneisium sulphate was used,in the treatment group.The hospitalization days and physicalsigns in lung were e-veluated in both groups.Results The treatment group in much better in both hospitalization days and physical signs in lung.Conclusion It' s effective and safe to use mucosolvan and magneisium sulphate in treatment of capillary bronchitis.