Objective To assess the efficacy and safety of nebulized hypertonic saline solution in infant with bronchiolitis.Methods From January 2014 to January 2016,95 patients at 3-13 months old in our hospital who diagnosed as bronchiolitis were randomly divided into three groups.On the basis of conventional suit support treatment,the observation group A was given nebulized 3％ hypertonic saline (n =32),the observation group B was given nebulized 3％ hypertonic saline and salbutamol (n =32),and the control group C was given nebulized normal saline (0.9％) and salbutamol (n =31),this therapy was repeated every 6 hours until discharge.The Lowell score,clinical symptoms remission time,days of hospitalization and incidence rate of adverse reaction of the three groups were compared.Results After treatment,the symptoms and signs of the three groups were all improved.The Lowell scores were lower in the two observation groups compared to the control group C in 24,48,72 hours after treatment[(5.81 ±1.53) points and (5.85 ± 1.37) points vs.(6.61 ± 1.54) points,(4.75 ± 1.34) points and (4.72 ± 1.30) points vs.(5.52 ± 1.29) points,(3.19 ± 1.15) points and (3.22 ± 1.16) points vs.(3.90 ± 1.01) points,Z =-1.999,-2.241,-2.518 and-2.002,-2.335,-2.316,all P ＜ 0.05).And the cough,wheezing remission time and pulmonary rales disappearance time,days of hospitalization in the two observation groups were also shorter,there were statistically significant differences [(6.63 ± 1.41) d and (6.56 ± 1.37) d vs.(7.35 ± 1.25) d,(5.19 ± 1.03) d and (5.25 ± 1.05)d vs.(5.87 ± 1.09)d,(5.75 ±1.34)d and (5.72 ± 1.51)d vs.(6.68 ± 1.60)d,(7.25 ± 1.37)d and (7.16±1.48)d vs.(8.10±l.47)d,Z=-2.498,-2.469,-2.359,-2.213 and-2.982,-2.405,-2.373,-2.222,P ＜0.05,or P ＜0.01)].There were no significant differences in the Lowell score,the length of time of cough,wheeze,lung rales disappears and the length of hospital stay between the observation group A and observation groupB[(5.81 ± 1.53) points vs.(5.85 ± 1.37) points,(4.75 ± 1.34) points vs.(4.72 ±1.30) points,(3.19± 1.15) points vs.(3.22 ± 1.16) points,(6.63 ± 1.41) d vs.(6.56 ± 1.37) d,(5.19 ±1.03)d vs.(5.25 ± 1.05)d,(5.75 ± 1.34) d vs.(5.72 ± 1.51) d,(7.25 ± 1.37) d vs.(7.16 ± 1.48) d,Z =-0.164,-0.021,-0.140,-0.295,-0.167,-0.374,-0.233,all P ＞ 0.05].Children in three groups had no serious adverse events (all P ＞ 0.05).Conclusion Nebulized hypertonic saline in the treatment of bronchiolitis can relieve symptoms and signs,shorten the hospitalization time,and has less adverse reaction,it is worthy of clinical use.

目的 评价20项神经运动检查法早期筛查0～6月龄高危儿脑损伤及其干预的效果,制定适宜的高危儿随访机制和方法.方法 该院收治的有脑损伤高危因素的新生儿218例,应用新生儿行为神经测定、每月定期20项神经运动检查进行神经运动发育系统评估,找出中枢神经系统可能存在发育落后或异常患儿,并以运动发育干预方法对其进行早期干预.随访监测高危儿神经发育,采用“评估→指导→训练→评估”的方法,以6月龄为终点,随访监测高危儿发育.结果 筛查出可疑脑损伤36例,予运动发育疗法干预,康复有效率达86.1％,早期被拟诊脑瘫5例转专科医院.结论 基层医疗保健机构中应建立围生期脑损伤高危儿筛查门诊,抓住生后最初6个月脑可塑性最强的时期,开展早期筛查和干预,是降低和减轻脑瘫发生率经济而有效的途径.

目的 探讨小儿哮喘急性发作期肺炎支原体(MP)、肺炎衣原体(CP)感染血清学变化.方法 选择265例哮喘急性发作期患儿(哮喘组)和90例健康体检儿童(对照组),采用酶联免疫吸附法检测入选儿童血清中的肺炎支原体抗体(MP-IgM)、肺炎衣原体抗体(CP-IgM),按照阳性结果标准比较分析.结果 哮喘组MP阳性率为32.1％(85/265),CP阳性率为14.0％(37/265),均高于对照组的14.4％(13/90)和4.4％(4/90),差异有统计学意义(P＜0.05);不同年龄段的哮喘急性发作期患儿MP阳性率比较差异有统计学意义(P＜0.05),而CP阳性率比较差异无统计学意义(P＞0.05).结论 对急性发作期的哮喘息儿进行MP-IgM、CP-IgM检测,能指导临床用药,有利于治疗.

新生儿窒息导致的缺氧缺血性心肌损伤是新生儿主要死亡原因之一,心肌损伤后多表现为心动过缓、血压低、循环不良,及时发现并给予早期干预治疗是降低新生儿死亡率的重要措施之一.

目的观察痰热清注射液治疗小儿急性上呼吸道感染的临床疗效。方法将136例小儿急性上呼吸道感染患儿随机分为治疗组72例与对照组64例,治疗组给予痰热清注射液静滴,对照组给予利巴韦林静滴;如合并细菌感染,均给予抗生素治疗,其它对症治疗相同。结果治疗组有效率高于对照组。结论痰热清注射液治疗小儿急性上呼吸道感染疗效确切,无明显不良反应。

血清MP-IgM抗体检测是诊断肺炎支原体感染的主要依据,但部分患儿早期MP-IgM抗体可呈阴性,有报道称发病后10d检测才阳性率高.为寻求更早诊断及减少漏诊,国内、外研究不少,报道较多,但少有肺炎支原体感染患者实验室指标动态变化的报道.