頭孢噻肟與丙種球蛋白配合對(duì)新生兒敗血癥的PCT、CRP、CD55及臨床療效的影響

戴秀鳳

[摘要] 目的 探討頭孢噻肟聯(lián)合丙種球蛋白治療新生兒敗血癥的臨床療效及對(duì)PCT、CRP、CD55的影響。方法 方便選取該院2016年1月—2019年1月收治的新生兒敗血癥患兒76例，根據(jù)不同治療方法分為兩組，對(duì)照組（n=38）接受頭孢噻肟治療，觀察組（n=38）在對(duì)照組基礎(chǔ)上接受丙種球蛋白治療，對(duì)比兩組患兒治療前后血清學(xué)指標(biāo)和臨床癥狀改善時(shí)間、住院時(shí)間、血培養(yǎng)轉(zhuǎn)陰率、臨床療效。結(jié)果 治療后觀察組患兒PCT、CRP、CD55水平分別為（1.77±0.44）ng/L、（11.52±4.31）mg/L、（31.47±12.47）MFI，對(duì)照組分別為（3.30±1.51）ng/L、（16.54±3.56）mg/L、（43.54±13.54）MFI，觀察組顯著低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（t=5.997、5.536、4.042，P<0.05）。觀察組體溫改善時(shí)間、神經(jīng)系統(tǒng)癥狀改善時(shí)間、拒奶改善時(shí)間、住院時(shí)間分別為（3.6±1.1）d、（6.2±1.7）d、（5.1±2.1）d、（7.6±2.1）d，對(duì)照組分別為（6.3±1.3）d、（8.9±1.9）d、（7.7±2.6）d、（11.7±2.8）d，兩組患兒對(duì)比差異有統(tǒng)計(jì)學(xué)意義（t=9.774、6.528、4.796、7.221，P<0.05）。兩組患兒血培養(yǎng)轉(zhuǎn)陰率對(duì)比，觀察組血培養(yǎng)轉(zhuǎn)陰率86.84%（33/38）顯著高于對(duì)照組57.89%（22/38），差異有統(tǒng)計(jì)學(xué)意義（χ2=20.955，P<0.05）。兩組患者臨床療效對(duì)比，觀察組總有效率89.47%（34/38）顯著優(yōu)于對(duì)照組71.05%（27/38），差異有統(tǒng)計(jì)學(xué)意義（χ2=10.708，P<0.05）。 結(jié)論 頭孢噻肟聯(lián)合丙種球蛋白可有效改善血清學(xué)指標(biāo)和臨床癥狀，促進(jìn)血培養(yǎng)轉(zhuǎn)陰，提高臨床療效，縮短住院時(shí)間，值得臨床推廣。

[關(guān)鍵詞] 頭孢噻肟;丙種球蛋白;新生兒

[中圖分類號(hào)] R985? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] A? ? ? ? ? [文章編號(hào)] 1674-0742（2020）01（b）-0088-03

Effects of Cefotaxime Combined with Gamma Globulin on PCT， CRP， CD55 and Clinical Efficacy of Neonatal Sepsis

DAI Xiu-feng

Department of Neonatology， Guanxian Central Hospital， Guanxian， Shandong Province， 252500 China

[Abstract] Objective To investigate the clinical efficacy of cefotaxime combined with gamma globulin in the treatment of neonatal sepsis and its effects on PCT， CRP and CD55. Methods 76 children with neonatal sepsis admitted convenient to the hospital from January 2016 to January 2019 were divided into two groups according to different treatment methods. The control group （n=38） received cefotaxime treatment， and the observation group （ n=38） on the basis of the control group， gamma globulin was treated. The serum and clinical symptoms improvement time， hospitalization time， blood culture conversion rate and clinical efficacy were compared before and after treatment. Results The levels of PCT， CRP and CD55 in the observation group were （1.77±0.44）ng/L， （11.52±4.31）mg/L and （31.47±12.47） MFI， respectively， and the control group was （3.30±1.51） ng/L， （16.54±3.56）mg/L， and （43.54±13.54）MFI were significantly lower in the observation group than in the control group，the difference was statistically significant（t=5.997， 5.536， 4.042， P<0.05）. The improvement time of body temperature， time of improvement of nervous system symptoms， time of improvement of milk rejection， and hospitalization time were （3.6±1.1）d， （6.2±1.7）d， （5.1±2.1）d，（7.6±2.1）d， respectively， and the control group was（6.3±1.3）d. （8.9±1.9）d， （7.7±2.6）d， （11.7±2.8）d， the difference between the two groups was statistically significant （t=9.774， 6.528， 4.796， 7.221， P<0.05）. The blood culture conversion rate of the two groups was significantly different. The blood culture conversion rate of the observation group was 86.84% （33/38）， which was significantly higher than that of the control group 57.89% （22/38）， the difference was statistically significant （χ2=20.955， P<0.05）. The clinical efficacy of the two groups was significantly different. The total effective rate of the observation group was 89.47% （34/38）， which was significantly better than that of the control group 71.05%， （27/38）， the difference was statistically significant （χ2=10.708， P<0.05）. Conclusion Cefotaxime combined with gamma globulin can effectively improve serum markers and clinical symptoms， promote blood culture， reduce clinical efficacy， shorten hospitalization time， and is worthy of clinical promotion.