1.Clinical Observation of Amoxicillin Sodium and Clavulanate Potassium Combined with Cranial Mild-mod-erate Hypothermia in the Treatment of Neonatal Hypoxic-ischemic Encephalopathy Complicating with Pul-monary Infection
Yancun CUI ; Yang LI ; Lili YAO
China Pharmacy 2016;27(20):2798-2800,2801
OBJECTIVE:To investigate the clinical efficacy and safety of amoxicillin sodium and clavulanate potassium com-bined with cranial mild-moderate hypothermia in the treatment of neonatal hypoxic-ischemic encephalopathy (HIE) complicating with pulmonary infection. METHODS:80 children with HIE complicating with pulmonary infection were randomly divided into ob-servation group(42 cases)and control group(38 cases). Control group received routine treatment under normal body temperature as lowering intracranial pressure,correcting acid-base balance,giving nutritional support and anticonvulsive treatment,and then was given amoxicillin sodium and clavulanate potassium 30 mg/kg intravenously,tid,more than 30 min each time,for consecutive 3 d. On the basis of control group,observation group was additionally given cranial mild-moderate hypothermia therapy:wearing cooling cap,at 10 ℃;keeping pharynx nasalis temperature at 34 ℃;keeping rectal temperature at 33-37 ℃;decreasing at rate of 1 ℃/h. They continued treatment for 3 d till body temperature decreased to 34.5 ℃;and then cooling cap was taken off to recover normal body temperature. Therapeutic efficacy of HIE and pulmonary infection were observed in 2 groups. NBNA score of 2 groups were recorded 1st,2nd and 4th week after birth,and the occurrence of ADR was observed. RESULTS:Total effective rate of HIE therapy (95.24% vs. 78.95%),cure rate of pulmonary infection (52.38% vs. 26.32%) and total effective rate (85.71% vs. 65.79%) in observation group were significantly higher than control group,with statistical significance (P<0.05). There was no statistical significance in NBNA score between 2 groups 1st week after birth(P>0.05). Compared to 1st week after birth,NBNA score were significantly improved 2nd and 4th week after birth,and the observation group were significantly higher than the control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Amoxicillin sodium and clavulanate potassium combined with cranial mild-moderate hypothermia is effec-tive for HIE complicating with pulmonary infection,and can effectively improve the prognosis of children with good safety.
2.Observation on effect of dopamine,phentolamine,recombinant interferon α combined with NCPAP in treating severe infantile bronchiolitis
Haiying SUN ; Yang LI ; Yancun CUI ; Xiaoning DU ; Lixia LIANG
Chongqing Medicine 2017;46(20):2782-2785
Objective To explore the clinical effect of dopamine,phentolamine,recombinant interferon α combined with nasal continuous positive airway pressure(CPAP) ventilation in treating severe infantile bronchiolitis.Methods Ninety-five cases of infantile severe bronchiolitis were divided into the observation group(55 cases) and control group (40 cases).The control group was given the combined treatment scheme of dopamine,phentolamine and recombinant interferon α,while on this basis the observation group was added with NCPAP.The curative effects were compared between the two groups.Results The total effective rate in the observation group was significantly higher than that in the control group(P<0.05);the temperature recovery time,wheezing disappearance time,cough stopping time,lung wheezing sound disappearance time and hospitalization time in the observation group were significantly lower than those in the control group(P<0.05);the breathing rate,heart rate and PaCO2 level after treatment in the two groups were significantly lower than those before treatment,the levels of PaO2,PaO2/FiO2 and pH were significantly higher than those before treatment in the same group,the differences were statistically significant(P<0.05);the breathing rate,heart rate and PaCO2 level after treatment in the observation group were significantly lower than those in the control group(P<0.05);the levels of PaO2,PaO2/FiO2 and PH after treatment in the observation group were significantly higher than those in the control group(P<0.05);the levels of IL-8,sVCAM-1and LTE4 after treatment in the two groups were significantly lower than those before treatment(P<0.05);there was no statistically significant difference in the levels of serum IL-8,sVCAM-1 and urine LTE4 between the two groups(P>0.05);the recurrence rate and death rate in the observation group were significantly lower than those in the control group with statistical difference(P<0.05);the occurrence rate of adverse situation during treatment period had no statistical difference between the two groups(P>0.05).Conclusion Dopamine,phentolamine,recombinant interferon α combined with NCPAP has obviously clinical effect for treating infantile severe bronchiolitis,can effectively improve the blood gas analytical indexes,reduces the signs and symptoms relief time,reduces the rates of relapse and death,and has higher clinical application value.