低剂量甲泼尼龙对急性化脓性骨髓炎伴脓毒血症患儿免疫功能及预后的影响

发布时间：2018-07-25 07:27

【摘要】：目的探究低剂量甲泼尼龙对急性化脓性骨髓炎伴脓毒血症患儿免疫功能及预后的影响,为临床治疗提供参考依据。方法将医院在2015年6月-2016年11月收治的79例急性化脓性骨髓炎伴脓毒血症的患儿,根据治疗方式的不同,分为激素组39例和常规组40例;观察两组患儿免疫功能改善及预后情况。结果 79例患儿中血培养出86株病原菌,以革兰阳性菌为主,共80株占93.02%;治疗前,两组患儿的CD_4~+与CD_8~+水平差异无统计学意义,但治疗后,激素组的CD_4~+与CD_8~+显著高于常规组,差异有统计学意义(P0.05);治疗后,激素组患儿向慢性骨髓炎发展的共占5.13%,死亡可完全避免,显著优于常规组,差异有统计学意义(P0.05)。结论低剂量甲泼尼龙辅助治疗急性化脓性骨髓炎伴脓毒血症的患儿,可明显调节免疫功能,显著改善预后,且常规行细菌培养及药敏分析,利于对接下来的诊治。
[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.
【作者单位】：海南省妇幼保健院小儿骨科;
【基金】：海南省自然科学基金资助项目(20168326)
【分类号】：R720.597;R726.8

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