【摘要】：目的探究低劑量甲潑尼龍對(duì)急性化膿性骨髓炎伴膿毒血癥患兒免疫功能及預(yù)后的影響,為臨床治療提供參考依據(jù)。方法將醫(yī)院在2015年6月-2016年11月收治的79例急性化膿性骨髓炎伴膿毒血癥的患兒,根據(jù)治療方式的不同,分為激素組39例和常規(guī)組40例;觀察兩組患兒免疫功能改善及預(yù)后情況。結(jié)果 79例患兒中血培養(yǎng)出86株病原菌,以革蘭陽(yáng)性菌為主,共80株占93.02%;治療前,兩組患兒的CD_4~+與CD_8~+水平差異無(wú)統(tǒng)計(jì)學(xué)意義,但治療后,激素組的CD_4~+與CD_8~+顯著高于常規(guī)組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);治療后,激素組患兒向慢性骨髓炎發(fā)展的共占5.13%,死亡可完全避免,顯著優(yōu)于常規(guī)組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論低劑量甲潑尼龍輔助治療急性化膿性骨髓炎伴膿毒血癥的患兒,可明顯調(diào)節(jié)免疫功能,顯著改善預(yù)后,且常規(guī)行細(xì)菌培養(yǎng)及藥敏分析,利于對(duì)接下來(lái)的診治。
[Abstract]:Objective to investigate the effect of low dose methylprednisolone on immune function and prognosis in children with acute suppurative osteomyelitis associated with sepsis. Methods from June 2015 to November 2016, 79 children with acute suppurative osteomyelitis with sepsis were divided into hormone group (n = 39) and routine group (n = 40). The immune function and prognosis of the two groups were observed. Results 86 strains of pathogenic bacteria were cultured in the blood of 79 cases, 80 strains were mainly Gram-positive bacteria (93.022%). Before treatment, there was no significant difference in CD4 ~ and CD8 ~ levels between the two groups, but after treatment, CD4 ~ and CD8 ~ in the hormone group were significantly higher than those in the routine group. The difference was statistically significant (P0.05); after treatment, the development of chronic osteomyelitis in the hormone group accounted for 5.13% of the total, death can be completely avoided, significantly better than the routine group, the difference was statistically significant (P0.05). Conclusion low dose methylprednisolone in the treatment of children with acute suppurative osteomyelitis with sepsis can significantly regulate immune function and improve prognosis. Routine bacterial culture and drug sensitivity analysis are helpful for subsequent diagnosis and treatment.
【作者單位】： 海南省婦幼保健院小兒骨科;
【基金】：海南省自然科學(xué)基金資助項(xiàng)目(20168326)
【分類(lèi)號(hào)】：R720.597;R726.8

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