盐酸普鲁卡因联合低分子肝素钠防治儿童紫癜肾炎疗效观察
|
摘要
目的观察盐酸普鲁卡因肾囊封闭联合低分子肝素钠防治儿童紫癜性肾炎与常规治疗组疗效比较。方法选择2015年6月至2018年2月收治的过敏性紫癜患儿84例为研究对象,其中男58例,女26例。按双盲法分为对照组和治疗组,每组42例。对照组按常规治疗,治疗组在常规治疗基础上加0.25%盐酸普鲁卡因1～1.5 ml/kg肾囊封闭,联合低分子肝素钠85～100 U·kg~(-1)·d~(-1)皮下注射。出院后门诊随诊6个月,对紫癜性肾炎发生例数、发生时间及尿蛋白、红细胞定量等进行比较,观察2组防治肾脏损害是否有显著性。结果治疗组过敏性紫癜患儿,于1个月、2个月、4个月、6个月肾损害的发生率分别为9.52%、7.14%、4.76%、0,治疗前后血尿及蛋白尿比较差异有统计学意义。对照组过敏性紫癜患儿于1个月、2个月、4个月、6个月肾损害的发生率分别为14.28%、 16.66%、11.90%、9.52%治疗前后血尿及蛋白尿比较差异无统计学意义(P>0.05)。结论盐酸普鲁卡因肾囊封闭联合低分子肝素钠降低儿童紫癜性肾炎发生,效果显著,具有临床实用价值。
Objective To investigate the therapeutic effects of procaine hydrochloride combined with low molecular weight heparin sodium in preventing and treating purpura nephritis in children,and to compare the therapeutic effects with those by conventional therapy.Methods A total of 84 children patients with allergic purpura who were admitted and treated in our hospital from June 2015 to February 2018 were enrolled as research objects,including 58 males and 26 females.According to double-blind method,these patients were divided into control group(n=42) and treatment group(n=42).The patients in control group were treated by conventional therapy,however,the patients in treatment group,on the basis of control group,wee treated by 0.25% procaine hydrochloride 1～1.5 ml/kg to seal the renal capsule and low molecular heparin sodium 85～100 U·kg~(-1)·d~(-1) by subcutaneous injection,with 6 month follow up after discharging from hospital.The incidence rate of purpura nephritis,onset time, and the changes of urine protein and erythrocyte were observed and compared between the two groups.Results The incidence rates of renal damage at 1 m,2 m,4 m and 6 m in treatment group were 9.52%,7.14%,4.76% and 0,respectively,there were significant differences in the hematuria and albuminuria before treatment and after treatment.And the incidence rates of renal damage in control group at 1 m,2 m,4 m and 6 m in treatment group were 14.28%,16.66%,11.90% and 9.52%,respectively,there were no significant differences in the hematuria and albuminuria before treatment and after treatment.Conclusion The procaine hydrochloride combined with low molecular heparin sodium can reduce the incidence rate of purpura nephritis in children,which has significant therapeutic effects and clinical practical value.
Objective To investigate the therapeutic effects of procaine hydrochloride combined with low molecular weight heparin sodium in preventing and treating purpura nephritis in children,and to compare the therapeutic effects with those by conventional therapy.Methods A total of 84 children patients with allergic purpura who were admitted and treated in our hospital from June 2015 to February 2018 were enrolled as research objects,including 58 males and 26 females.According to double-blind method,these patients were divided into control group(n=42) and treatment group(n=42).The patients in control group were treated by conventional therapy,however,the patients in treatment group,on the basis of control group,wee treated by 0.25% procaine hydrochloride 1～1.5 ml/kg to seal the renal capsule and low molecular heparin sodium 85～100 U·kg~(-1)·d~(-1) by subcutaneous injection,with 6 month follow up after discharging from hospital.The incidence rate of purpura nephritis,onset time, and the changes of urine protein and erythrocyte were observed and compared between the two groups.Results The incidence rates of renal damage at 1 m,2 m,4 m and 6 m in treatment group were 9.52%,7.14%,4.76% and 0,respectively,there were significant differences in the hematuria and albuminuria before treatment and after treatment.And the incidence rates of renal damage in control group at 1 m,2 m,4 m and 6 m in treatment group were 14.28%,16.66%,11.90% and 9.52%,respectively,there were no significant differences in the hematuria and albuminuria before treatment and after treatment.Conclusion The procaine hydrochloride combined with low molecular heparin sodium can reduce the incidence rate of purpura nephritis in children,which has significant therapeutic effects and clinical practical value.
引文
1 胡亚美,江载芳主编.诸福棠实用儿科学.第7版.北京:人民卫生出版社,2005.688-690.
2 王雁凌.低分子肝素钠防治过敏性紫癜患儿肾脏损害的临床研究.临床医药实践,2010,7:504-505.
3 彭禾.肾囊封闭.中级医刊,1958,2:54-56.
4 李肇基.普鲁卡因肾囊封闭治疗一例顽固性呃逆及二例支气管哮喘疗效报告.铁道医学,1979,1:54-55.
5 莫樱,陈述牧.紫癜性肾炎的发病机制与病理诊断.中国实用儿科杂志,2006,21:407-410.
6 汉吉鸿,冷为雪.低分子肝素治疗原发性肾病综合征临床研究.中华临床医学实践杂志,2004,3:549-550.
7 吴升华主编.儿科住院医师手册.第3版.南京:江苏科学技术出版社,2013.257-264.
8 赵艳君,马步国.低分子肝素钙联合普通肝素钠抗凝治疗对原发性肾病综合征患儿尿蛋白和高凝状态的影响.广西医学,2019,41:174-176.
9 华柯.低分子肝素钠和右旋糖酐对肾病综合征高凝状态治疗效果的影响研究.中国医药科学,2018,8:33-36.
10 许见萍.低分子肝素钠治疗儿童腹型过敏性紫癜的临床效果分析.基层医学论坛,2018,22:677-679.
11 王丽琴.低分子肝素钠治疗过敏性紫癜疗效分析.临床医药文献杂志,2018,5:137-139.
12 白芝蕙.低分子肝素钠治疗难治性肾病综合征临床疗效分析.基层医学论坛,2017,21:3988-3989.
13 杨志华,沈玉鹏,张彦军.普鲁卡因“封闭疗法”治疗小儿过敏性紫癜的疗效观察.中国优生优育,2013 19:631-633.
14 陆海山,郭剑,孙华凤,等.普鲁卡因大静脉封闭疗法治疗腹型过敏性紫癜疗效观察 .人民军医,2015,58:785-786.
15 钮丽芳.小剂量肝素钠治疗急性肾小球肾炎临床效果观察.世界最新医学信息文摘,2016,16:199-203.
16 赵天平.小剂量肝素治疗儿童过敏性紫癜对预防紫癜性肾炎的临床观察.中国社区医师,2014,30:67-68.
17 吴丽云.应用低分子肝素钙预防紫癜性肾炎.中国医药科学,2017,7:55-57.
18 杨静.用低分子肝素钠辅助治疗过敏性紫癜肾炎的效果研究.当代医药论丛,2016,14:111-112.
19 范伟.低分子肝素钠防治儿童紫癜性肾炎临床疗效观察.山西职工医学院学报,2014,24:37-38.
20 申昆玲,黄国英主编.儿科学.第1版.北京.人民卫生出版社,2018.512-517.
2 王雁凌.低分子肝素钠防治过敏性紫癜患儿肾脏损害的临床研究.临床医药实践,2010,7:504-505.
3 彭禾.肾囊封闭.中级医刊,1958,2:54-56.
4 李肇基.普鲁卡因肾囊封闭治疗一例顽固性呃逆及二例支气管哮喘疗效报告.铁道医学,1979,1:54-55.
5 莫樱,陈述牧.紫癜性肾炎的发病机制与病理诊断.中国实用儿科杂志,2006,21:407-410.
6 汉吉鸿,冷为雪.低分子肝素治疗原发性肾病综合征临床研究.中华临床医学实践杂志,2004,3:549-550.
7 吴升华主编.儿科住院医师手册.第3版.南京:江苏科学技术出版社,2013.257-264.
8 赵艳君,马步国.低分子肝素钙联合普通肝素钠抗凝治疗对原发性肾病综合征患儿尿蛋白和高凝状态的影响.广西医学,2019,41:174-176.
9 华柯.低分子肝素钠和右旋糖酐对肾病综合征高凝状态治疗效果的影响研究.中国医药科学,2018,8:33-36.
10 许见萍.低分子肝素钠治疗儿童腹型过敏性紫癜的临床效果分析.基层医学论坛,2018,22:677-679.
11 王丽琴.低分子肝素钠治疗过敏性紫癜疗效分析.临床医药文献杂志,2018,5:137-139.
12 白芝蕙.低分子肝素钠治疗难治性肾病综合征临床疗效分析.基层医学论坛,2017,21:3988-3989.
13 杨志华,沈玉鹏,张彦军.普鲁卡因“封闭疗法”治疗小儿过敏性紫癜的疗效观察.中国优生优育,2013 19:631-633.
14 陆海山,郭剑,孙华凤,等.普鲁卡因大静脉封闭疗法治疗腹型过敏性紫癜疗效观察 .人民军医,2015,58:785-786.
15 钮丽芳.小剂量肝素钠治疗急性肾小球肾炎临床效果观察.世界最新医学信息文摘,2016,16:199-203.
16 赵天平.小剂量肝素治疗儿童过敏性紫癜对预防紫癜性肾炎的临床观察.中国社区医师,2014,30:67-68.
17 吴丽云.应用低分子肝素钙预防紫癜性肾炎.中国医药科学,2017,7:55-57.
18 杨静.用低分子肝素钠辅助治疗过敏性紫癜肾炎的效果研究.当代医药论丛,2016,14:111-112.
19 范伟.低分子肝素钠防治儿童紫癜性肾炎临床疗效观察.山西职工医学院学报,2014,24:37-38.
20 申昆玲,黄国英主编.儿科学.第1版.北京.人民卫生出版社,2018.512-517.