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目的:探讨不同剂量丙种球蛋白联合地塞米松治疗儿童特发性血小板减少性紫癜(ITP)的临床疗效。方法:选择2010年7月至2015年7月间我院收治的特发性血小板减少性紫癜患儿78例,按照随机数字表法将其分为观察组38例及对照组40例。观察组采用200 mg/(kg·d)丙种球蛋白联合地塞米松进行治疗,对照组采用400 mg/(kg·d)丙种球蛋白联合地塞米松进行治疗。对两组患者的临床疗效、治疗前后血小板计数、血小板上升时间、血小板恢复正常时间、出血停止时间、住院时间、不良反应及医疗费用进行观察。结果:两组患儿血小板计数治疗前无显著差异(P>0.05),治疗后两组血小板计数均呈逐渐升高趋势(P<0.05),但组间比较无统计学差异(P>0.05)。两组患儿血小板上升时间、血小板恢复正常时间、出血停止时间及住院时间均接近,无统计学差异(P>0.05)。观察组治疗总有效率为94.74%,对照组为95.00%,两组无显著差异(P>0.05)。观察组不良反应发生率为8.17%,对照组为12.50%,两者相比无统计学差异(P>0.05)。观察组患儿平均医疗费用为(1.25±0.34)万元,对照组患儿平均医疗费用为(2.31±0.40)万元,观察组明显低于对照组,两者差异有统计学意义(P<0.05)。结论:不同剂量丙种球蛋白联合地塞米松治疗ITP具有类似的临床疗效及安全性,但小剂量丙种球蛋白组治疗费用明显降低,因此值得临床推广应用。
Objective: To investigate the clinical efficacy of different dosages of gamma globulin combined with dexamethasone in the treatment of idiopathic thrombocytopenic purpura (ITP) in children. Methods: From July 2010 to July 2015, 78 children with idiopathic thrombocytopenic purpura admitted to our hospital were divided into observation group (38 cases) and control group (40 cases) according to random number table method. The observation group was treated with 200 mg / (kg · d) gamma globulin combined with dexamethasone, while the control group was treated with 400 mg / (kg · d) gamma globulin combined with dexamethasone. The clinical efficacy, platelet count, platelet rise time, platelet recovery time, bleeding stop time, hospital stay, adverse reactions and medical costs were observed before and after treatment. Results: There was no significant difference in platelet counts between the two groups before treatment (P> 0.05). After treatment, the platelet count of both groups showed a trend of increasing (P <0.05), but there was no significant difference between the two groups (P> 0.05) . The platelet rise time, platelet recovery time, bleeding stop time and hospital stay in both groups were similar, with no significant difference (P> 0.05). The observation group, the total effective rate was 94.74%, 95.00% in the control group, no significant difference between the two groups (P> 0.05). The incidence of adverse reactions in the observation group was 8.17% and in the control group was 12.50%, there was no significant difference between the two groups (P> 0.05). The average medical cost in the observation group was (1.25 ± 0.34) million yuan and the average medical cost in the control group was (2.31 ± 0.40) million yuan, the observation group was significantly lower than that of the control group (P < 0.05). CONCLUSION: ITP with different dosages of gamma globulin combined with dexamethasone has similar clinical efficacy and safety. However, the cost of low-dose gamma globulin therapy is significantly reduced, so it is worthy of clinical application.