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目的探究锌制剂辅助治疗婴幼儿重症肺炎的效果。方法选取2013年1月至2015年12月来广东省妇幼保健院儿科就诊的重症肺炎患儿108例,依据抽签法将患儿分为补锌组和对照组,各54例。根据药物敏感试验两组患儿均给予敏感抗生素治疗,补锌组患儿在此基础上口服葡萄糖酸锌片(70~105 mg/次,每日2次);对照组患儿给予同等剂量的淀粉片。观察比较两组患儿治疗前及治疗1周后呼吸频率、血氧饱和度、血红蛋白、红细胞沉降率(ESR)、C反应蛋白、降钙素原、血清锌水平,比较两组患儿治疗前后喘息率、呻吟样呼吸率、中心性发绀率、进食困难率、餐后呕吐率以及发热、咳嗽、呼吸困难、临床症状持续时间;比较两组患儿的疗效。结果治疗1周后,补锌组患儿呼吸频率水平显著低于对照组[(27.4±3.0)次/min比(29.5±3.5)次/min]、血氧饱和度显著高于对照组(0.97±0.02比0.96±0.03),差异有统计学意义(P<0.05)。补锌组患儿血红蛋白显著高于对照组[(158±24)g/L比(147±26)g/L,(18.3±4.2)μmol/L比(11.0±1.8)μmol/L],ESR、C反应蛋白、降钙素原的水平显著低于对照组[(13.8±2.6)mm/1 h比(17.6±3.5)mm/1 h、(16±5)mg/L比(19±6)mg/L、(1.7±0.4)μg/L比(2.0±0.7)μg/L]。补锌组患儿喘息率、呻吟样呼吸率、中心性发绀率、进食困难率、餐后呕吐率明显低于对照组[9.26%(5/54)比29.63%(16/54)、1.85%(1/54)比12.96%(7/54)、0.00%(0)比7.41%(4/54)、1.85%(1/54)比12.96%(7/54)、3.70%(2/54)比14.81%(8/54)],差异有统计学意义(P<0.05);补锌组患儿发热、咳嗽、呼吸困难及临床症状持续时间均显著低于对照组[(3.8±0.9)d比(4.3±0.9)d、(4.6±1.1)d比(5.2±1.1)d、(16.9±2.5)h比(23.8±4.9)h、(6.9±2.0)d比(8.4±2.8)d](P<0.01),补锌组患儿的总治愈率显著高于对照组[94.44%(51/54)比81.48%(44/54)],差异有统计学意义(P<0.05),其疗效也高于对照组。结论应用锌剂辅助常规治疗可明显改善重症肺炎患儿的临床症状,在缩短治疗时间的同时还能有效提高总治愈率。
Objective To explore the effect of zinc preparations in the treatment of infantile severe pneumonia. Methods From January 2013 to December 2015, 108 children with severe pneumonia admitted to the pediatric department of Guangdong MCH hospital were enrolled. According to the drawing method, 54 children were divided into zinc supplementation group and control group. According to the drug susceptibility test, both groups of children were given sensitive antibiotics. The zinc supplementation group took oral zinc gluconate tablets (70-105 mg / time twice daily) on the basis of this. In the control group, the same dose of Starch tablets. The respiratory rate, oxygen saturation, hemoglobin, erythrocyte sedimentation rate (ESR), C-reactive protein, procalcitonin, and serum zinc levels in two groups before and after treatment were observed and compared between before and after treatment Breathing rate, moan-like respiration rate, central cyanosis rate, eating difficulty rate, postprandial vomiting rate and fever, cough, dyspnea, duration of clinical symptoms; the efficacy of the two groups were compared. Results After 1 week of treatment, the respiratory rate of children in the zinc-supplementation group was significantly lower than that of the control group (27.4 ± 3.0) / min (29.5 ± 3.5) / min, and the oxygen saturation was significantly higher than that of the control group (0.97 ± 0.02 vs 0.96 ± 0.03), the difference was statistically significant (P <0.05). The hemoglobin in the zinc supplementation group was significantly higher than that in the control group [(158 ± 24) g / L vs (147 ± 26) g / L, (18.3 ± 4.2) μmol / L vs , C-reactive protein and procalcitonin were significantly lower than those in the control group [(13.8 ± 2.6) mm / 1 h vs (17.6 ± 3.5) mm / 1 h and (16 ± 5) mg / L vs ) mg / L, (1.7 ± 0.4) μg / L (2.0 ± 0.7) μg / L]. The rates of wheezing, groaning breathing, central cyanosis, eating difficulty and postprandial vomiting were significantly lower in the zinc supplementation group than those in the control group [9.26% (5/54) vs 29.63% (16/54), 1.85% (1/54) vs 12.96% (7/54), 0.00% (0) vs 7.41% (4/54), 1.85% (1/54) vs 12.96% (7/54), 3.70% (2/54) ) Was 14.81% (8/54)], the difference was statistically significant (P <0.05). The fever, cough, dyspnea and the duration of clinical symptoms in the zinc supplementation group were significantly lower than those in the control group [(3.8 ± 0.9) d ratio of (4.3 ± 0.9) d, (4.6 ± 1.1) d vs (5.2 ± 1.1) d, (16.9 ± 2.5) h vs (23.8 ± 4.9) h, (6.9 ± 2.0) d vs (8.4 ± 2.8) d (P <0.01). The overall cure rate in children with zinc supplementation was significantly higher than that in the control group [94.44% (51/54) vs 81.48% (44/54)], with statistical significance (P <0.05) Its efficacy is also higher than the control group. Conclusion The application of zinc as adjunctive routine therapy can significantly improve the clinical symptoms of severe pneumonia in children, shorten the treatment time but also effectively improve the overall cure rate.