Effects of Dexamethasone combined with Meropenem in treatment of children with refractory purulent meningitis
Objective:To observe effects of Dexamethasone combined with Meropenem in treatment of children with refractory purulent meningitis.Methods:The clinical data of 78 children with refractory purulent meningitis admitted to this hospital from October 2020 to October 2023 were retrospectively analyzed.According to different treatment methods,they were divided into control group and study group,39 cases in each group.Both groups were given routine treatment.On this basis,the control group was treated with Meropenem,while the study group was treated with Dexamethasone on the basis of that of the control group.Both groups were treated for 1 week.The clinical efficacy,the levels of clinical related indexes(recovery time of body temperature,disappearance time of meningeal irritation sign,recovery time of white blood cell count),the levels of inflammatory factors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),procalcitonin(PCT)]and the serological indexes[matrix metalloproteinase-9(MMP-9),soluble B7 homolog 3(sB7-H3)]before and after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of treatment in the study group was 94.87%(37/39),which was higher than 79.49%(31/39)in the control group,and the difference was statistically significant(P<0.05).The recovery time of body temperature,the disappearance time of meningeal irritation sign and the recovery time of white blood cell count in the study group were shorter than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of CRP,TNF-α,PCT,MMP-9 and sB7-H3 in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Dexamethasone combined with Meropenem in the treatment of the children with refractory purulent meningitis can improve the total effective rate of treatment,improve the levels of clinical related indexes,and reduce the levels of inflammatory factors and serological indexes.Moreover,it is superior to simple Meropenem treatment.
万方数据
维普
