目的 探究氫化可的松聯(lián)合阿昔洛韋在治療小兒重癥病毒性腦炎中的臨床療效。方法 選擇2017年1月—2019年1月于濮陽市油田總醫(yī)院接受治療的98例重癥病毒性腦炎患兒作為研究對象，按照隨機(jī)數(shù)字表法將患者分為對照組和觀察組，每組各49例。對照組患兒iv阿昔洛韋注射液，應(yīng)用劑量為40 mg/d，2次/d，治療時(shí)間為14 d；觀察組患兒在對照組基礎(chǔ)上iv氫化可的松注射液，應(yīng)用劑量為100 mg/d，3～5 d后減一次半量，激素治療時(shí)間為7 d。觀察兩組患兒的臨床療效，比較兩組患兒體溫恢復(fù)時(shí)間、驚厥消失時(shí)間、肢體癱瘓恢復(fù)時(shí)間、昏迷恢復(fù)時(shí)間和血清神經(jīng)元特異性烯醇化酶（NSE）水平。結(jié)果 治療后，觀察組治療總有效率為87.76%，顯著高于對照組的71.43%，兩組總有效率比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，觀察組體溫恢復(fù)時(shí)間、驚厥消失時(shí)間、肢體癱瘓恢復(fù)時(shí)間、昏迷恢復(fù)時(shí)間均短于對照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療第3、5、10天時(shí)，觀察組NSE水平均顯著低于對照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 氫化可的松聯(lián)合阿昔洛韋對小兒重癥病毒性腦炎具有較好的治療效果，能夠加快患兒臨床癥狀改善，降低其血清NSE水平，同時(shí)治療安全性較高，值得進(jìn)行臨床推廣。

Objective To explore the efficacy of hydrocortisone combined with acyclovir in treatment of severe viral encephalitis in children. Methods 98 children with severe viral encephalitis in Puyang Oilfield General Hospital from January 2017 to January 2019 were divided into control and observation group according to random number table method, and each group had 49 cases. Children in the control group were iv administered with Aciclovir Injection at 40 mg/d for twice daily, and the treatment time was 14 d. Children in the observation group were iv administered with Hydrocortisone Injection on the basis of control group, and the dose was 100 mg/d. After 3-5 d, the dose was reduced by half once, and the duration of hormone therapy was 7 d. After treatment, the clinical efficacy in two groups were observed, and the temperature recovery time, convulsion disappearance time, limb paralysis recovery time, coma recovery time, and the serum NSE level in two groups were compared. Results After treatment, the total effective rate in the observation group was 87.76%, which was significantly higher than 71.43% in the control group, the difference between two groups was statistically significant (P<0.05). After treatment, the time of temperature recovery, convulsion disappearance, limb paralysis recovery, and coma recovery in the observation group were significantly shorter than those in the control group, the difference between two groups was statistically significant (P<0.05). At the 3rd, 5th and 10th day of treatment, the NSE level in the observation group was significantly lower than that in the control group, and the difference between the two groups was statistically significant (P<0.05).Conclusion Hydrocortisone combined with acyclovir has a good therapeutic effect on severe viral encephalitis in children, which can accelerate the improvement of clinical symptoms and reduce the serum NSE level in children. Meanwhile, the treatment is relatively safe, and worthy of clinical promotion.

R971