Objective To compare the clinical efficacy of cefixime and cefaclor in treatment of children with acute bacterial enteritis and effects of TNF alpha, IL-8,PCT.Methods Eighty-six cases of children with acute bacterial enteritis were selected, which were treated in hospital from February 2015 to February 2016, and they were divided into the A group (43 cases) and B group (43 cases).The patients of two groups were all treated with conventional treatment, basic nutrition support, maintain acid base balance, and correct electrolyte imbalance, and antiemetic, correct dehydration, rehydration and other symptomatic treatment.On the basis of basis treatment, the patients of the A group were treated with cefixime 2 mg/kg, twice a day,while the patients of B group were treated with cefaclor 10 mg/kg,twice a day.The patients of two groups were all continuing oral administration of 3-5 d after normal stool and a course of which were 7d.The ineffective patients replacement of antibiotics after treatment of 3d, it was not applied to other anti-diarrheal drugs or other antibiotics during treatment.When the children had symptom of high fever, using antipyretic for treatment, and when children had severe symptoms, intravenous in-fusion of electrolyte solution for treatment.Compare the clinical efficacy, improvement of clinical symptoms, the incidence of adverse reactions, and changes of the levels of TNF-α, IL-8, PCT of two groups.Results The total efficiency of the observa-tion group was 90.7%, higher than 72.1% in the control group (χ2 =4.914, P =0.027); compared with before treatment, serum TNF-α, IL-8, lower the level of PCT in 2 groups after treatment, and the observation group than the control group de-creased significantly ( t =13.946, t =4.745, t =5.298, P <0.05), the observation group stool frequency normal time, stool recovery time, cooling time, hospitalization time was significantly shorter than the control group, the stool negative rate was significantly higher than the control group ( t /χ2 =24.384,20.603,22.172,9.716,22.216, P <0.05);the 2 groups in the process of occurrence of allergic dermatitis,drug rash,changes in sleep and blood the reaction and other adverse symptoms, but the difference was not statistically significant(χ2 =1.625,χ2 =1.316,χ2 =0.443,χ2 =1.625, P >0.05).Conclusion The clinical efficacy of cefixime in the treatment of patients with acute bacterial enteritis is better than cefaclor,can effectively control the serum inflammatory index,relieve symptoms,high safety,is conducive to the prognosis of patients,worthy of clinical application.%目的：比较头孢克肟与头孢克洛治疗急性细菌性肠炎患儿的临床疗效及对 TNF－α、IL－8、PCT 的影响。方法选取2015年2月—2016年2月山东省济宁市邹城市兖矿集团公司总医院儿科收治急性细菌性肠炎患儿86例作为研究对象，按照随机数字表法分为观察组43例和对照组43例。2组患儿入院后行常规处理，基础营养支持，维持酸碱平衡，纠正电解质紊乱，并给予止吐、纠正脱水、补液等对症处理。完成基础治疗后，观察组给予头孢克肟2 mg／kg 口服，2次／d。对照组给予头孢克洛10 mg／kg 口服，2次／d。大便正常后继续口服3～5 d，2组患儿疗程均为7 d；治疗3 d 后无效者更换抗生素，治疗过程中均不应用其他止泻药物或其他抗生素。出现高热症状时给予退热剂，严重症状患儿给予静脉滴注电解质液。比较2组患者临床疗效，治疗前后血清 TNF－α、IL－8、PCT 水平，临床症状改善情况，并记录不良反应。结果观察组临床总有效率为90．7％，高于对照组的72．1％（χ2＝4．914， P ＝0．027）；与治疗前比较，2组患儿治疗后血清 TNF－α、IL－8、PCT 水平降低，且观察组较对照组降低明显（ t ＝13．946、4．745、5．298， P＜0．05），观察组大便次数恢复正常时间、大便性状恢复正常时间，退热时间、住院时间显著较对照组短，大便转阴率明显高于对照组（ t ／χ2＝24．384、20．603、22．172、9．716、22．216， P 均＜0．05）；2组患儿治疗过程中发生过敏性皮炎、药疹、睡眠改变、血液反应等不良症状，但差异无统计学意义（χ2＝1．625、1．316、0．443、1．625， P 均＞0．05）。结论头孢克肟治疗急性细菌性肠炎患者临床疗效确切，优于头孢克洛，能有效控制血清炎性指标，缓解临床症状，安全性高，有利于患者预后，值得临床推广应用。
展开▼
