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目的探讨糖皮质激素联合丙种球蛋白治疗儿童急性播散性脑脊髓炎(ADEM)的临床疗效。方法 43例儿童ADEM患儿,根据治疗方法不同分为治疗组(22例)和对照组(21例)。两组均给予常规治疗,在此基础上对照组给予糖皮质激素治疗,治疗组给予糖皮质激素联合丙种球蛋白治疗。对比分析两组患儿的意识障碍、颈项强直、发热持续时间及平均住院时间。结果治疗组意识障碍、颈项强直、发热时间及平均住院时间分别为(2.15±1.13)、(7.07±0.96)、(1.67±0.62)、(14.23±3.04)d均明显短于对照组的(5.01±1.52)、(10.16±1.98)、(4.67±1.02)、(18.70±3.96)d,差异有统计学意义(P<0.01);治疗组总有效率为90.91%(20/22),高于对照组的80.95%(17/21),差异有统计学意义(P<0.05)。结论 ADEM应尽早明确诊断,糖皮质激素联合丙种球蛋白治疗可更有效改善患儿的临床症状,提高治疗有效率。
Objective To investigate the clinical efficacy of glucocorticoid combined with gamma globulin in the treatment of childhood acute disseminated encephalomyelitis (ADEM). Methods 43 children with ADEM were divided into treatment group (n = 22) and control group (n = 21) according to different treatment methods. Both groups were given routine treatment, on the basis of the control group given glucocorticoid treatment, the treatment group given glucocorticoid combined with gamma globulin treatment. Comparative analysis of two groups of children with disturbance of consciousness, neck stiffness, duration of fever and the average length of stay. Results The scores of consciousness disturbance, neck stiffness, fever duration and average length of hospital stay in the treatment group were (2.15 ± 1.13), (7.07 ± 0.96), (1.67 ± 0.62) and (14.23 ± 3.04) d respectively, which were significantly shorter than those in the control group ± 1.52), (10.16 ± 1.98), (4.67 ± 1.02) and (18.70 ± 3.96) d, respectively (P <0.01). The total effective rate in the treatment group was 90.91% (20/22) The control group 80.95% (17/21), the difference was statistically significant (P <0.05). Conclusion ADEM should be diagnosed as soon as possible. Glucocorticoid combined with gamma globulin can effectively improve the clinical symptoms of children and improve the treatment efficiency.