目的 评价阿奇霉素序贯疗法治疗小儿支原体肺炎的临床疗效及药物经济学效果。方法 将我院儿科于2011年3月—2013年8月收治的522例支原体肺炎患儿随机分为静滴组(n=265)和序贯组(n=287),两组均给予阿奇霉素进行疗程为5 d的治疗,静滴组采用静脉滴注的给药方法进行治疗,序贯组采用静脉滴注2 d后口服序贯给药3 d的方法进行治疗,运用药物经济学原理对两种给药方案进行成本－效果分析。结果 静滴组和序贯组的总有效率分别为94.0%(249/265)和92.7%(266/287),两组比较差异无统计学意义(P>0.05),但静滴组的成本高于序贯组(P<0.01);静滴组和序贯组的不良反应发生率分别为34.7%(92/265)和26.9%(76/287),两组比较差异有统计学意义(P<0.05)。结论 采用序贯疗法治疗小儿支原体肺炎符合安全、有效、经济的临床用药原则,值得临床广泛推荐。

Objective To evaluate the clinical efficacy and pharmacoeconomic effect of sequential therapy of azithroycin on treatment of community mycoplasmal pneumonia(MP)in chindren. Methods 522 cases with MP from March 2011 to August 2013 in pediatrics department of our hospital were randomly divided into intravenous-drip group(n=265)and sequential-therapy group(n=287),and both two groups were treated by azithromycin for 5 days.The intravenous-drip group was treated with intravenous drip of azithromycin,and the sequential-therapy group was treated with azithromycin in the way of intravenous drip for 2 days and oral-taken for 3 days.The two treatments were cost-effectiveness analyzed by pharmacoeconomic theory. Results The total efficiency of the sequential-therapy group and intravenous-drip group were 94.0%(249/265)and 92.7%(266/287),respectively.There was no different between the sequential-therapy group and the intravenous-drip group(P<0.05).But the cost in intravenous-drip group was higher than that in sequential-therapy group(P<0.01).The incidence of adverse reaction of the sequential-therapy group and intravenous-drip group were 94.0% 34.7%(92/265)and 26.9%(76/287),respectively.And it was significant different between the two groups(P<0.05). Conclusions The treatment of sequential therapy of azithromycin is safety,effective and economical.And it is worthy to be widely recommended in clinical.

目的 研究探讨小儿支气管肺炎应用穿心莲内酯磺化物雾化吸入治疗的临床疗效及安全性。方法 选取2012年7月—2014年6月我院收治并确诊的128例小儿支气管肺炎患儿为研究对象,将所有患儿随机分为对照组和观察组各64例。两组患儿均给予常规退热,消炎、镇咳、平喘、抗病毒感染等治疗,对照组患儿在常规治疗基础上采用红霉素、青霉素和头孢等药物治疗,观察组患儿在常规治疗基础上采用喜炎平注射液雾化吸入治疗,观察两组患儿治疗后退烧时间、肺部啰音消失时间、咳嗽消失时间、临床总有效率以及住院天数。结果 治疗后观察组患儿的各症状消失时间以及住院天数均短于对照组患儿,差异有统计学意义(P<0.05)。观察组患儿总有效率为96.88%高于对照组的85.94%,两组差异有统计学意义(P<0.05)。结论 采用喜炎平注射液雾化吸入治疗小儿支气管肺炎有效果,能效缓解患儿的临床症状,值得大力推广。

Objective To Study and investigate the curative effect and security using nebulizer inhalation of Andrographolide Sulfonate to children's bronchopneumonia. Methods From July,2012 to June, 2014, we chose 128 children who had been diagnosed as bronchopneumonia by our hospital as our research subjects, and divided them into the contrast group and the observation group randomly with 64 children each. The both groups were all treated by using the methods of Antipyretic,anti-inflammatory,antitussive,antiasthmatic,anti-viral infection, treated by using erythromycin, penicillin and cefotaxime in the contrast group,treated the observation group by using Xiyanpin injection by nebulizer inhalation, of cause these two treatment were all on the basis of the conventional treatment. After treatment, we recorded the exact time of when the fever was gone, the disappearing time of pulmonary rales and their cough, the total effective rate and the time of being in hospital of the two groups. Results The time of all the observation group's symptom disappearing and being in hospital was obviously shorter than that of the contrast group after treatment. The difference between both groups was statistically significant(P<0.05). The total effective rate for the observation group was 96.88%, and it's higher than the contrast groups',which was 85.94%. The difference was statistically significant(P<0.05)too. Conclusion Using Xiyanpin injection by nebulizer inhalation for children's bronchopneumonia could effectively relieve the children's clinical symptom. It is worth popularizing for its good clinic medical value.

目的 探讨急性阑尾炎(acute appendicitis, AA)及急性感染性肠炎(acute infectious enteritis, AIE)患儿的阑尾高频超声影像特点及其显像敏感性。方法 回顾性分析临床确诊为急性阑尾炎患儿120例,急性感染性肠炎患儿160例,并对其行高频超声检查,另设120例正常儿童为对照组。分析高频超声阑尾显示率,阑尾外径,阑尾周围系膜炎性变化以及阑尾的位置等情况。结果 AA组、AIE组、对照组阑尾的显示率分别为96.7%、80.6%、68.3%,差异有统计学意义(P<0.05)。三组超声显示的阑尾外径分别为(8.5±2.2)mm、(4.3±0.8)mm、(3.5±0.7)mm,相互间差异亦均有统计学意义(P<0.05)。AA组所有的阑尾周围系膜炎症改变均可探及,但AIE组的阑尾周围系膜无变化。结论 小儿急性阑尾炎高频超声显像敏感性高,旨在为临床对AA早期诊断、早期治疗提供较准确全面的影像学依据。

Objective Use high-frequency ultrasound to determine the frequency of visualization and image feature of the appendix in children with acute appendicitis (acute appendicitis, AA) and with acute infectious enteritis (acute infectious enteritis, AIE). Methods The ultrasonic features of 120 children with AA, 160 children with AIE, and 120 randomly selected asymptomatic children were analyzed retrospectively. And their visualization rate, outer appendiceal diameter, presence or absence of inflamed periphery appendiceal mesenterium, and location of the appendix were recorded. Results The visualization rates of the appendix were 96.7%, 80.6%, and 68.3% for AA groups, AIE groups, and the control, respectively(P<0.05). The outer appendiceal diameters for the 3 groups were (8.5±2.2)mm, (4.3±0.8)mm, and (3.5±0.7)mm. Difference among the 3 groups was statistically significant also. Periphery appendiceal inflamed mesenterium was detected in all AA cases, but in none of the AIE cases. Conclusion High ultrasound imaging sensitivity of puerile acute appendicitis provided relatively accurate comprehensive imaging basis for clinical early diagnosis and early treatment.

目的 探讨本中心引起儿童泌尿系统感染的常见病原菌的分布以及耐药情况,为临床合理选用抗菌药物提供参考。方法 回顾性分析本医疗中心2012年1月—2013年12月2463例泌尿系统感染患儿中段尿标本培养及药敏检测结果。结果 2463例患儿中段尿标本共培养病原菌479株,阳性率为19.45%。其中革兰阴性杆菌309株(64.51%),革兰阳性球菌138株(28.81%),真菌32株(6.68%,主要为白假丝酵母菌)。分离率前7位的病原菌依次为大肠埃希菌(36.53%)、肺炎克雷伯菌(12.73%)、粪肠球菌(D群)(12.32%)、屎肠球菌(D群)(10.23%)、真菌(6.68%)、铜绿假单胞菌(5.22%)、奇异变形菌(3.13%),革兰氏阴性杆菌以大肠埃希菌和肺炎克雷伯菌为主,其中产超广谱β‐内酰胺酶菌株125株,比例高达71.42%;革兰阳性球菌以肠球菌(D群)为主,金黄色葡萄球菌检出率为2.30%,其中耐甲氧西林株占27.27%。结论 大肠埃希菌仍为儿童泌尿系统感染的主要病原菌,且存在多重耐药菌感染情况,革兰氏阳性球菌有增多的趋势;明确病原菌种类及药敏结果,对临床合理应用抗菌药物治疗儿童泌尿系统感染有重要意义。

Objective To research the distribution of common pathogenic bacteria and drug resistance of urinary tract infection in the hospital for providing reference of antimicrobial drugs for clinical reference. Methods Pathogenic bacteria isolated from the germiculture positive specimens of midstream urine and the antimicrobial susceptibility test results from Jan 2012 to Dec 2013 in our hospital were retrospective summarized. Results 479 strains pathogenic bacteria were isolated from 2463 urine samples totally. The positive rate was 17.3％, with 309 strains of gram-negative bacilli (64.51％),138 strains of gram-positive coccus(28.81％),32 strains of fungi(6.68％).The top 7 isolation of pathogens were strains of escherichia coli(36.53％),strains of klebsiella pneumoniae(12.73％),strains of enterococcus faecalis D group(12.32％),strains of enterococcus faecium D group(10.23％),strains of fungi(6.68％),strains of pseudomonas aeruginosa(5.22％),strains of staphylococcus epidermidis(3.13％).125 strains of klebsiella pneumoniae produced ESBL were detected out with the rates of up to 71.42%. The strains of gram-negative bacteria were based on enterococcus faecalis (D group),yet staphylococcus aureus methicillin resistant strains accounted for 27.27%. Conclusion Escherichia coli is the main pathogenic bacteria of child urinary tract infection and the multidrug resistance of the pathogenic bacteria is in a very serious situation. And gram-positive cocci is going to be increasing. It is necessary to make clear pathogens and drug sensitivity results, which is important to guide clinic make use of antibacterial agents exactly to cure infection of urinary system in children.

目的 研究比较低流量异氟烷与七氟烷麻醉在小儿腹腔镜手术中的麻醉效果。方法 选取在我院进行腹腔镜手术治疗的小儿患者120例作为研究对象,随机分为异氟烷和七氟烷两组,每组各60例,分别采用低流量异氟烷和七氟烷进行麻醉,比较两组患儿的相关麻醉参数,以及入睡、苏醒、拔管时间和不良反应情况。结果 两组患儿的不同时期脉搏氧饱和度、心率、呼气末二氧化碳浓度比较无差异(P＞0.05);七氟烷组患儿的不同时期的平均动脉压具有较强的稳定性,而异氟烷组患儿在诱导期间、手术过程中平均动脉压降低,差异有统计学意义(P＜0.05)。结论 在小儿腹腔镜手术过程,采用低流量七氟烷进行麻醉,可以使手术过程中血流动力学更加稳定,缩短术后拔管时间,减少术后不良反应发生,更易满足小儿腹腔镜手术的麻醉要求。

Objective To investigate efficacy between low flow isoflurane and sevoflurane in pediatric laparoscopic surgery. Methods 120 cases of children underwent laparoscopic surgery in our hospital were randomly divided into two groups. 60 patients in isoflurane group were given low-flow isoflurane anesthesia; 60 patients in sevoflurane group were given low-flow isoflurane anesthesia. Heart rate (HR), mean arterial blood pressure (MAP), pulse oxygen saturation (SpO₂), end-tidal partial pressure of carbon dioxide (EtCO₂) at different period, sleep and awakening time, extubation time, and adverse reactions of two groups were observed. Results Heart rate (HR), pulse oxygen saturation (SpO₂), end-tidal partial pressure of carbon dioxide (EtCO₂) of two groups at different period had no significantly difference (P>0.05). Mean arterial blood pressure (MAP) of two groups at different period had significantly difference (P<0.05). The sleep time and recovery time of two groups had no significant difference (P>0.05). The extubation time of sevoflurane was significantly lower than isoflurane group (P<0.05). The adverse reaction rate of sevoflurane was significantly lower than isoflurane group (P<0.05). Conclusion Low flow isoflurane and sevoflurane can be used in pediatric laparoscopic surgery, and the efficacy of sevoflurane is better.

       目的   探讨中医药治疗小儿腺样体肥大（AH）的研究现状、研究热点及趋势，为本领域研究者提供借鉴。方法   检索中国知网（CNKI）数据库从2005年1月1日至2024年1月31日中医药治疗小儿腺样体肥大的相关文献。运用Excel 2019分析其发文量，运用CiteSpace 6.2.R6软件分析其作者、机构、关键词。结果   共纳入文献395篇，年发文量整体呈现波动上升的趋势；发文量最多的作者为姜之炎；发文量最多的研究机构为山东中医药大学。初步形成了以姜之炎、俞景茂、阎兆君为核心的研究团队；研究机构以中医类院校及其附属医院为主。高频关键词提示当前研究热点前三位为中医药治疗方法、临床疗效。结论  AH领域研究内容主要以内治法、外治法、作用机制为主；研究热点逐渐从临床研究转向作用机制等实验研究；应用“数据挖掘”“网络药理学”等计算机技术研究AH会成为趋势。

       Objective  To explore the research status，research hotspots，and trends of traditional Chinese medicine in the treatment of adenoid hypertrophy in children，to provide a reference for researchers in this field．Methods  The relevant literature on the treatment of adenoid hypertrophy in children with traditional Chinese medicine was searched in the CNKI database from January 1，2005，to January 31，2024．Excel 2019 was applied to analyze the number of published papers，and CiteSpace 6.2.R6 software was applied to analyze its authors，institutions，and keywords．Results  A total of 395 papers were included，and the annual number of papers showed a fluctuating upward trend．The author with the largest number of papers was JIANG Zhiyan．Shandong University of Traditional Chinese Medicine was the research institution with the largest number of papers．The core  research teams including JIANG Zhiyan，YU Jingmao，and YAN Zhaojun were initially formed．The  research institutions were mainly Chinese medicine colleges and their affiliated hospitals．High-frequency keywords suggest that the current top three research hotspots were traditional Chinese medicine treatment methods，clinical efficacy．Conclusions  The research content in this field is mainly based on internal treatment，external treatment，and mechanism．The focus has gradually shifted from clinical research to experimental research such as mechanism．The application of computer technologies such as “data mining” and “network pharmacology” for this disease will become a trend．