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红霉素联合阿奇霉素序贯疗法与单用阿奇霉素治疗小儿支原体肺炎的效果比较

Comparison of the effect of Erythromycin combined with Azithromycin Sequential therapy and Azithromycin in treatment of mycoplasma pneumonia in children

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【作者】 杨立新

【Author】 YANG Lixin;Department of Pediatrics, Aviation General Hospital of China;

【机构】 航空总医院儿科

【摘要】 目的对比小儿支原体肺炎采用红霉素联合阿奇霉素的序贯疗法与单独使用阿奇霉素治疗的临床效果以及安全性。方法将2013年4月~2014年4月航空总医院儿科确诊的支原体肺炎患儿90例根据数字表法随机分为对照组和观察组,每组45例。所有患儿入院后卧床休息,进行常规对症治疗和护理干预。对照组患儿采用单纯阿奇霉素序贯疗法,阿奇霉素连续静脉滴注4 d,之后阿奇霉素干混悬剂连续口服3 d,停用4 d后再重复进行2~3个疗程。观察组患儿采用红霉素联合阿奇霉素的序贯疗法,先口服环酯红霉素干混悬剂4~6 d,之后阿奇霉素干混悬剂连续口服3 d,停用4 d后再重复进行2~3个疗程。对比两组临床效果、两组患儿退热时间、咳嗽消失时间、肺部湿音消失时间、胸片阴影消失时间、住院时间以及不良反应发生率。结果观察组临床有总效率比对照组明显提高(P<0.05);观察组患儿退热时间、咳嗽消失时间、肺部湿音消失时间、胸片阴影消失时间以及住院时间均比对照组明显缩短(P<0.05);观察组患儿发生恶心呕吐、腹痛腹泻、静脉炎、皮疹、肝功能异常等不良反应的情况比对照组明显降低(P<0.05)。结论红霉素联合阿奇霉素的序贯疗法,能明显改善小儿支原体肺炎的临床症状体征,缩短治疗时间,安全性高,能充分发挥红霉素和阿奇霉素的协同治疗作用,效果明显优于单纯阿奇霉素序贯疗法,可在临床推广应用。

【Abstract】 Objective To compare the clinical efficacy and safety of erythromycin combined with Azithromycin Sequential therapy and Azithromycin in treatment of mycoplasma pneumonia in children. Methods From April 2013 to April2014, 90 children with mycoplasma pneumonia in Aviation General Hospital were randomly divided into the control group and the observation group according to the digital table method, 45 cases in each group. All the children stayed in bed and rested in bed, and were given the routine symptomatic treatment and nursing intervention. The control group was treated with Azithromycin Sequential therapy, Azithromycin continuous intravenous drip for 4 days, then Azithromycin dry suspension was oral for 3 days, after 4 days discontinuation, repeated 2-3 courses of treatment. The observation group was treated with erythromycin, Azithromycin Sequential therapy, Erythromycin dry suspension oral for 3 days at first, then Azithromycin dry suspension oral for 3 days, after 4 days discontinuation, repeated 2-3 courses of treatment.The clinical effect, the fever clearance time, the disappearance time of cough, pulmonary rales and chest X-ray shadow, hospitalization time and incidence of adverse reactions were compared between the two groups. Results The total effective rate in the observation group was significantly higher than that in the control group(P < 0.05); defervescence time, cough disappeared time and lung wet rales lost time, chest X-ray shadow disappear time and hospitalization time in the observation group was significantly shorter than those in the control group(P < 0.05); Nausea and vomiting, abdominal pain, diarrhea, phlebitis, skin rash, liver dysfunction and other adverse reactions in the observation group was significantly lower than those in the control group(P < 0.05). Conclusion The sequential therapy of erythromycin combined with azithromycin can improve the clinical symptoms and signs, shorten the treatment time of mycoplasma pneumoniae pneumonia in children, and is of high security; it can give full play to the effect of erythromycin and azithromycin in the treatment, its effect is better than simple Azithromycin Sequential therapy, which can be used in clinical application.

【关键词】 红霉素; 阿奇霉素; 序贯疗法; 小儿; 支原体肺炎; 有效; 不良反应;

【Key words】 Erythromycin; Azithromycin; Sequential therapy; Children; Mycoplasma pneumonia; Effective; Adverse reactions;

【分类号】R978.15;R45;R563.13;

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