目的   探讨口服水合氯醛与鼻内给予右美托咪定中深度镇静下行泪道探通术治疗婴幼儿先天性泪道阻塞的疗效、并发症及安全性。方法   随机选择2021年2月—2023年6月在广州医科大学附属妇女儿童医疗中心就诊的先天性泪道阻塞患儿，将其分为观察组和对照组，观察组行中深度镇静后进行泪道探通术，对照组进行表麻下泪道探通术，对比两组的治愈率及并发症发生率。结果   观察组共76例（97眼），总治愈率98.97%，分为3组，6~12月龄组41例（53眼），12~18月龄组14例（15眼），18~36月龄组21例（29眼），对照组共84例（116眼），总治愈率93.10%，6~12月龄组55例（70眼），12~18月龄组15例（24眼），18~36月龄14例（22眼），观察组泪道探通术治愈率高于对照组，差异有统计学意义（χ ² =4.49，P＜0.05）。观察组一次探通的成功率为92.78%，高于对照组61.21%，差异有统计学意义（χ ² =26.86，P＜0.05）。观察组二次探通的成功率为85.71%，高于对照组44.44%，差异有统计学意义（χ ² =4.13，P＜0.05）。发生的并发症主要是出血、皮下水肿、感染、假道形成，观察组并发症的发生率4.12%，低于对照组15.52%，差异有统计学意义（χ ² =7.40，P＜0.05）。观察组中2例患儿口服水合氯醛出现恶心呕吐，改为右美托咪定滴鼻。3例患儿右美托咪定滴鼻后出现口唇苍白，持续10～15 min即可缓解。其余均未有不良反应。结论   中深度镇静下给予婴幼儿泪道阻塞患儿行泪道探通术相比传统表麻下泪道探通术疗效更好，并发症较少，对孩子的心理创伤小，安全且经济实惠。

       Objective  To explore the efficacy，complications and safety of moderate and deep  sedation  under oral administration of chloral hydrate and intranasal administration of dexmedetomidine for the treatment of congenital nasolacrimal duct obstruction（CNLDO） in infants and young children．Methods  Children with CNLDO who visited our hospital from February 2021 to June 2023 were randomly selected and divided into the observation group and the control group．The observation group was performed with lacrimal duct probing after moderate and deep sedation，while the control group was performed with lacrimal duct probing under surface anesthesia．The cure rate and incidence of complications were compared between the two groups．Adverse reactions after using sedatives were observed．Results  The observation group consisted of 76 cases（97 eyes），with a total cure rate of 98.97%．They were divided into three groups：41 cases（53 eyes）in the aged 6-12 months group，14 cases（15 eyes）in the aged 12-18 months group，and 21 cases（29 eyes）in the aged 18-36 months group．The control group consisted of 84 cases（116 eyes），with a total cure rate of 93.10%．There were 55 cases（70 eyes）in the aged 6-12 months group，15 cases（24 eyes）in the aged 12-18 months group，and 14 cases（22 eyes）in the aged 18-36 months group．The cure rate of lacrimal duct probing in the observation group was significantly higher than that in the control group（χ ² =4.49，P＜0.05）．The success  rate of the first probing in the observation group was 92.78%，significantly higher than that in the control group of 61.21%（χ ² =26.86，P＜0.05）．The success rate of the second probing in the observation group was 85.71%，significantly higher than that in the control group of 44.44%（χ ² =4.13，P＜0.05）．The incidence of complications mainly were bleeding，subcutaneous edema，infection，and false passage formation．The incidence of complications in the observation group was 4.12%，lower than that in the control group 15.52%，and the difference was statistically significant（χ ² =7.40，P＜0.05）．Two cases in the observation group experienced nausea and vomiting after taking chloral hydrate orally，and were replaced with dexmedetomidine nasal drops．Three cases of pediatric patients showed pale lips after nasal administration of dexmedetomidine，which lasted for 10-15 minutes and could be relieved．No other adverse reactions were observed．Conclusions  Under moderate and deep sedation，lacrimal duct probing treatment for infants and young children with CNLDO showed better therapeutic effects，fewer complications，less psychological trauma to these patients，which is safe and cost-effective，and is suitable for promotion compared to under traditional surface anesthesia．

目的 探讨免疫球蛋白（Ig）与超敏C-反应蛋白（hs-CRP）联合在幼儿手足口病病情中的应用价值。方法 选取2021年1月—2023年4月广州市妇女儿童医疗中心接受诊治的160例手足口病患儿作为观察组,依据其病情严重程度将其分为普通型98例、重症型62例;并选取同期健康体检儿童160名作为对照组。于观察组入组时、对照组体检时采集静脉血,对所有受试者进行IgG、IgA、IgM与hs-CRP检测,对比观察组、对照组和轻症型、重症型的指标水平,分析上述指标诊断效能。结果 观察组hs-CRP、IgM高于对照组,IgG、IgA低于对照组（P<0.05）;轻症型hs-CRP、IgM均低于重症型患儿,IgG、IgA均高于重症型患儿（P<0.05）;ROC曲线分析,hs-CRP、IgG、IgA、IgM联合对幼儿手足口病的诊断敏感性最高,为87.50%,AUC=0.952（0.922~0.973）,约登指数为0.769。结论 免疫球蛋白联合hs-CRP能够明显提高幼儿手足口病的诊断敏感性,可作为评价患儿病情严重程度的参考指标检测。

目的 探讨多维铁口服液联合维生素AD滴剂治疗婴幼儿缺铁性贫血的疗效。方法 将首次诊断缺铁性贫血的336例婴幼儿依家长意愿分为2个治疗组(A组和B组)与1个对照组,A组予多维铁口服液联合维生素AD滴剂治疗,B组予多维铁口服液联合维生素D滴剂治疗,对照组饮食调理并补充维生素AD,于治疗4周后(3天内)采末梢血行血细胞分析,比较三组患儿贫血治疗显效率、总有效率差异。结果 治疗4周后,A组显效率为71.70%,总有效率为97.17%;B组显效率为41.05%,总有效率为90.30%;对照组显效率为6.25%,总有效率为32.29%。A组贫血治疗显效率、总有效率高于B组和对照组,差异均有统计学意义(P<0.05)。结论 铁剂联合维生素A制剂可显著提高婴幼儿缺铁性贫血的治疗效果。

Objective To observe the curative effect of multivitamin iron oral solution combined with vitamin AD drops on the treatment of iron deficiency anemia in infants. Methods 336 cases of infants who was found with iron deficiency anemia for the first time were divided into two treatment groups (group A and group B) and one control group in accordance with their parents' will. Group A was treated with multivitamin iron oral solution combined with vitamin AD drops. Group B was treated with multivitamin iron oral solution combined with vitamin D drops. The control group was taken just dietary therapy combined with vitamin AD drops. All subjects were tested blood analysis after 4 weeks of treatment (within 3 days). The differences of the treatment excellence rates and the total effective rates were compared in the three groups. Results After 4 weeks of treatment, the excellence rate in group A was 71.70%. The total effective rate in group A was 97.17%. The excellence rate in group B was 41.05%. The total effective rate in group B was 90.30%. The excellence rate in control group was 6.25%. The total effective rate in control group was 32.29%. The differences of the treatment excellence rates and the total effective rates in group A were significantly higher than those in group B or in the control group. The differences were statistically significant (P<0.05). Conclusion Multivitamin iron combined with vitamin A can significantly improve the curative effect of the treatment of iron deficiency anemia in infants.

目的 通过对婴幼儿泌尿系感染并发脓毒症的临床特点、病原菌情况及相关因素的分析,探讨其早期诊断和及时治疗的措施。方法 选取83例我科收治的确诊泌尿系感染合并脓毒症的婴幼儿作为研究对象,回顾性分析其临床表现、实验室检查及治疗预后情况。结果 所选婴幼儿均确诊泌尿系感染合并脓毒症,以男性患儿多见,全身中毒症状重,6月以下多以严重脓毒症、脓毒性休克为首诊表现,尿路刺激症状不明显。有明显细菌感染生物标记物的改变。细菌学培养共检出细菌22株,大肠埃希菌占54.55% (12/22),对头孢吡肟较为敏感,对亚胺培南、美罗培南全部敏感;屎肠球菌占22.73%(5/22),对万古霉素、利奈唑胺、替考拉宁敏感。结论 在婴幼儿常见的感染部位中,泌尿系感染容易被忽略。而小于6月的患儿更易并发严重脓毒症、脓毒症休克等危重症。因此,以脓毒症为首诊表现的婴幼儿应特别警惕泌尿系感染,尽可能早期明确感染部位,防止漏诊。首诊1小时内给予广谱抗生素治疗,可降低婴幼儿脓毒症的病死率,改善患儿预后。

Objective By analyzing the clinical features, laboratory tests, pathogenic bacteria culture and the treatments of infants and toddlers with urinary tract infection UTI accompanied with sepsis, we aim to guide the further clinical treatments and prevention. Methods We selected 83 cases from January 1, 2014 to December 31, 2016 in our hospital as the research objects which were accepted the diagnosis and treatments of urinary tract infection complicated with sepsis. Its clinical manifestations, laboratory tests, bacteriology examination and treatment prognosis were retrospectively analyzed. Results Among the selected infants and toddlers diagnosed with urinary tract infection complicated with sepsis, male patients were more common. Symptoms of systemic poisoning were observed in the majority especially in the children aging under 6 months, with severe sepsis and septic shock as the first manifestation, while conventional symptoms were not obvious. Biological markers of bacterial infection were significantly changed. In bacterial culture, 22 strains of bacteria were detected, Escherichia coli accounted for 54.55% (12/22), were almost sensitive to cefepime, and all sensitive to imipenem and meropenem; Enterococcus following accounted for 22.73% (5/22), could be more sensitive to vancomycin, linezolid, teicoplanin. Conclusion Urinary tract infection is common in under 3 years old babies. Patients aging under 6 months are more likely to be complicated with severe sepsis and septic shock. Therefore, we should be especially vigilant of the UTI among the babies whose first manifestations appear to be sepsis only. It is important to find out the site of infection as early as possible, in order to prevent misdiagnosis. It is also critical to use broad-spectrum antimicrobial therapy within 1 hour when severe sepsis is diagnosed in order to reduce the mortality of sepsis in infants and improve the prognosis.

目的 探讨盐酸普萘洛尔凝胶外涂治疗婴幼儿浅表性血管瘤的疗效及安全性。方法 选取我院2015年5月—2017年5月收治的60例患有浅表性血管瘤的婴幼儿为研究对象,随机分为观察组和对照组,各30例。对照组口服盐酸普萘洛尔片治疗,观察组采用质量浓度为5 g/L的(20 g∶100 mg)盐酸普萘洛尔凝胶外涂方法治疗,疗程3个月。观察两组患者治疗效果及不良反应情况。结果 治疗后,采用Achauer评定疗效,观察组Ⅰ级患儿1例,Ⅱ级患儿6例,Ⅲ级患儿12例,Ⅳ级患儿8例,Ⅴ级患儿3例,总有效率为96.67%(29/30),对照组Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级、Ⅴ级分别为2例、8例、10例、6例、4例,总有效率为93.33%(28/30),两组患者差异无统计学意义(P>0.05);两组患者治疗后血管瘤血流峰值及阻力系数较治疗前均得到改善(P<0.05),而两组间差异均无统计学意义(P>0.05);不良反应情况,除观察组发生3例涂抹部位发红外,两组患者均未发生严重不良反应。结论 采用盐酸普萘洛尔凝胶外涂治疗婴幼儿浅表性血管瘤疗效显著,安全可靠,临床上值得进一步推广。

Objective To evaluate the efficacy and safety of Propranolol hydrochloride gel in the external application treatment of superficial hemangioma in infants. Methods We selected 60 infants with superficial hemangioma treated in our hospital from May 2015 to May 2017 and to randomly divide them into the observation group and the control group, each with 30 cases. The control group was treated with Propranolol hydrochloride tablets, and the observation group was treated with 0.5% (20 g∶100 mg) Propranolol hydrochloride gel external application method, the course of treatment was 3 months.We observed the therapeutic effects and adverse reactions of the two groups. Results After treatment, with the Achauer evaluation, patients with grade Ⅰ had 1 case, grade Ⅱ 6 cases, grade Ⅲ 12 cases, grade Ⅳ 8 cases, Ⅴ-grade 3 cases, and the total effective rate was 96.67% (29/30), while the grade Ⅰ, Ⅱ, Ⅲ, Ⅳ, Ⅴ in the control group included 2 cases, 8 cases, 10 cases, 6 cases, 4 cases, and the total effective rate was 93.33% (28/30), there was no significant difference between the two groups (P>0.05); The hemangioma peak flow and resistance coefficient of patients in the two groups were significantly improved than that before the treatment (P<0.05), and all with no statistically significant difference between the two groups (P>0.05). As to the adverse reactions, except the applying parts of 3 cases having rubefaction occurred in the observation group, two groups of patients had no serious adverse reactions. Conclusion External application of Propranolol hydrochloride gel in the treatment of superficial hemangioma in infants is effective, safe and reliable. It is worthy of further promotion in clinic.

目的 研究布拉氏酵母菌在合理治疗婴幼儿肠炎中的应用分析。方法 随机分组,观察组、对照组各60例病例,总例数120例,年龄均在2岁以下。观察组予以布拉氏酵母菌进行治疗;对照组采用常用的消化道黏膜保护剂(蒙脱石散)加微生态制剂(双歧杆菌四联活菌片)两联治疗。判定两组疗效。判定标准分为:大便次数及性状改变、发热、呕吐缓解、心酶下降、电解质紊乱、脱水纠正。结果 总有效率观察组为96.7％,对照组为86.7%,观察组临床疗效优于对照组(P<0.05),在各项症状及临床指标的改善上也优于对照组。结论 布拉氏酵母菌治疗婴幼儿肠炎临床疗效较常规方法能更好地缓解症状,使用更简单、合理,未监测到不良反应,值得在临床药物选择使用。

目的 观察以湿敷为主的早期综合干预疗法治疗婴幼儿湿疹的效果。方法 按照随机的原则对118例患有湿疹的婴幼儿分为观察组(60例)和对照组(58例)。观察组采取以湿敷为主的早期综合治疗,对照组采取一般家庭干预,两组均跟踪随访,观察湿疹的好转情况,并统计湿疹复发率。结果 观察组60例患者中痊愈38例,占 63.3%;显效20例,占 33.3%;有效2例,占3.3%;无效0例;总有效率100%。痊愈的38例中,随访8周后重新出现湿疹的病例为8例,复发率为21%。对照组58例患者中痊愈20例,占 34.48%;显效14例,占24.14%;有效16例,占27.59%;无效8例,占13.79%;总有效率86.21%。观察组痊愈的38例中,随访8周后重新出现湿疹的病例为8例,复发率为21%。对照组痊愈20例中复发6例,复发率为30%。结论 以湿敷为主的早期综合干预疗法能有效减轻湿疹的症状,可以作为社区治疗婴幼儿湿疹的参考。

Objective To observe the effects of wet compress based early comprehensive intervention therapy in the treatment of infant eczema. Methods 118 cases of infantile eczema within the jurisdiction were randomly divided into observati on group (60 cases)and control group (58 cases). The observation group was given early comprehensive therapy based on wet compress while the control group took general family intervention.Follow-up observations were adopted for both groups to examine the curing of eczema and to collect data for eczema recurrence. Results In the observation group of 60 cases, 38 were cured, accounting for 63.3%; 20 markedly improved (33.3%),2 effective(3.3%) and 0 ineffective; with the total effective rate of 100%.of the 38 cases cured, eczema reappeared in 8 cases after eight weeks of follow-up observation, with the recurrence rate of 21%. In the control group of 58 cases, 20 were cured, accounting for 34.48%; 14markedly improved (24.14%), 16 effective (27.59%),and 8 ineffective (13.79%),with the total effective rate of 86.21%. In the observation group, eczema recurred in 8 of the 38 cured cases after eight weeks of follow-up observation, with the recurrence rate of 21% while in the control group, eczema recurred in 6 cases, with the recurrence rate of 30%. Conclusion Wet compress based early comprehensive intervention therapy can effectively relieve the symptoms of eczema, so it can be effectively used in community treatment of infantile eczema.