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目的:探讨亚低温联合纳洛酮治疗小儿病毒性脑炎的临床效果及其对于患儿脑脊液中CRP,IL-6及TNF-α的影响。方法:利用随机数字表法将180例病毒性脑炎患儿分为试验组90例(常规治疗+亚低温联合纳洛酮)和对照组90例(仅使用常规治疗)。两组疗程均为14 d,治疗结束后,比较两组临床疗效及不良反应情况。同时在治疗的第0、7、14天分别抽取两组患儿脑脊液,检测两组患儿脑脊液中CRP,IL-6及TNF-α变化情况。结果:试验组和对照组总有效率分别为95.6%和83.3%,其差异具有统计学意义(P<0.05);试验组和对照组不良反应发生率分别为2.3%和3.3%,两组并无统计学差异(P>0.05);相比对照组,试验组患儿脑脊液中CRP,IL-6及TNF-α改善的水平分别均优于对照组,其差异具均有统计学意义(P<0.05)。结论:亚低温联合纳洛酮治疗小儿病毒性脑炎临床疗效确切,并能够降低炎性细胞因子,保护神经元细胞,改善脑部神经功能。
Objective: To investigate the clinical effect of mild hypothermia combined with naloxone on children with viral encephalitis and its effect on cerebrospinal fluid in children with CRP, IL-6 and TNF-α. Methods: A total of 180 children with viral encephalitis were divided into experimental group (n = 90) and conventional group (n = 90). The two courses of treatment were 14 d, after treatment, the clinical efficacy and adverse reactions were compared between the two groups. At the same time, two groups of children’s cerebrospinal fluid were collected on the 0, 7 and 14 days of treatment to detect the changes of CRP, IL-6 and TNF-α in the cerebrospinal fluid of the two groups. Results: The total effective rates of the experimental group and the control group were 95.6% and 83.3%, respectively, with statistical significance (P <0.05). The adverse reactions in the experimental group and the control group were 2.3% and 3.3% (P> 0.05). Compared with the control group, the levels of CRP, IL-6 and TNF-α in cerebrospinal fluid of the experimental group were significantly better than those of the control group (P <0.05). Conclusion: Mild hypothermia combined with naloxone in the treatment of infantile viral encephalitis is clinically effective and can reduce inflammatory cytokines, protect neurons and improve neurological function in the brain.