地塞米松和口服甘油在降低细菌性脑膜炎患儿听力和神经后遗症中的作用。
Role of dexamethasone and oral glycerol in reducing hearing and neurological sequelae in children with bacterial meningitis.
机构信息
Department of Pediatrics, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
出版信息
Indian Pediatr. 2007 Sep;44(9):649-56.
OBJECTIVE
To investigate the efficacy of dexamethasone and oral glycerol in reducing hearing and neurological sequelae in children with acute bacterial meningitis (ABM).
DESIGN
Prospective double blind, placebo controlled randomized study.
SETTING
Pediatric services of a tertiary care teaching and referral hospital.
SUBJECTS
Children 2 months to 12 years with a diagnosis of acute bacterial meningitis admitted between June 2002 to September 2003.
INTERVENTION
Subjects were assigned randomly to receive dexamethasone, glycerol, dexamethasone+glycerol or placebo. Neurological and hearing impairment was assessed at discharge and after 1 month.
RESULTS
58 children (48 boys, 10 girls), mean age 50.2 +/- 41.0 months, were studied. Twelve patients received dexamethasone, 13 glycerol, 20 dexamethasone + glycerol and 13 placebo. Bacterial etiology was ascertained in 24 patients: Streptococcus pneumoniae-10, H influenzae b-7, Staph. aureus-5 and others-2. Three (5.2%) children died during hospital stay and 55 survived. Seven (12%) patients had neurological sequelae (3 in glycerol, 3 in dexamethasone+glycerol, 1 in placebo group, P = 0.29), and 10 patients (17%) had hearing sequelae (2 in glycerol, 3 in dexamethasone, 2 dexamethasone + glycerol and 3 in placebo group, P = 0.68).
CONCLUSION
No significant difference was seen in neurological or hearing outcome with use of either glycerol or dexamethasone in children with acute bacterial meningitis.
目的
研究地塞米松和口服甘油在降低儿童急性细菌性脑膜炎（ABM）听力和神经后遗症方面的疗效。
设计
前瞻性双盲、安慰剂对照随机研究。
地点
一家三级保健教学和转诊医院的儿科服务。
对象
2002 年 6 月至 2003 年 9 月期间确诊为急性细菌性脑膜炎并入院的 2 个月至 12 岁儿童。
干预措施
将患儿随机分为地塞米松组、甘油组、地塞米松+甘油组和安慰剂组。出院时和 1 个月后评估神经和听力损伤。
结果
共纳入 58 例患儿（男 48 例，女 10 例，平均年龄 50.2±41.0 个月）。12 例患儿接受地塞米松治疗，13 例患儿接受甘油治疗，20 例患儿接受地塞米松+甘油治疗，13 例患儿接受安慰剂治疗。24 例患儿的细菌病因明确：肺炎链球菌 10 例，流感嗜血杆菌 b 型 7 例，金黄色葡萄球菌 5 例，其他菌 2 例。3 例（5.2%）患儿在住院期间死亡，55 例存活。7 例（12%）患儿有神经后遗症（甘油组 3 例，地塞米松+甘油组 3 例，安慰剂组 1 例，P=0.29），10 例患儿有听力后遗症（甘油组 2 例，地塞米松组 3 例，地塞米松+甘油组 2 例，安慰剂组 3 例，P=0.68）。
结论
在急性细菌性脑膜炎患儿中，使用甘油或地塞米松治疗在神经或听力结局方面无显著差异。
Zotero 插件