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目的探讨阿昔洛韦治疗小儿急性上呼吸道感染(AUPI)患儿不良反应发生情况及特点,为临床儿科合用使用阿昔洛韦提供参考。方法回顾性选取2010年1月至2015年10月茂名市电白区妇幼保健院收治的4782例AURI患儿的病例资料,所有患儿均采用阿昔洛韦进行治疗,采集并统计患者一般情况、不良反应发生时间、涉及器官及临床表现、联合用药情况、处理情况和转归。结果 4782例患儿中,发生不良反应58例,占1.2%,其中发生不良反应患儿以4~9岁为主;第1次使用阿昔洛韦注射液发生不良反应患儿20例,发生率为34.5%,连续使用阿昔洛韦注射液2次以上才出现不良反应38例,发生率为65.5%;其中发生不良反应最快为静脉滴注后2 min,最迟为第8天;阿昔洛韦最主要的不良反应为急性肾衰竭,其次为皮肤反应;58例患儿均有联合用药情况,其中以联合2种药物为主,其次为联合1种药物;58例患儿经停药或对症处理后,48例治愈,占83.8%;9例好转,占15.5%;1例转入肾内科接受治疗,经专科治疗后好转出院。结论临床使用阿昔洛韦治疗AUPI患儿应严格掌握本药使用原则,了解患儿全身情况,遵循个体化用药,注意用药剂量及滴注速度,以减少不良反应发生。
Objective To investigate the occurrence and characteristics of acyclovir in children with acute upper respiratory tract infection (AUPI) and provide a reference for the combination of acyclovir in clinical pediatrics. Methods The data of 4782 children with AURI admitted to Dianbai Maternal and Child Health Hospital of Maoming City from January 2010 to October 2015 were retrospectively selected. All children were treated with acyclovir, and the general condition of the patients was collected and counted , The timing of adverse reactions, involving organs and clinical manifestations, combined medication, treatment and outcome. Results Among the 4782 children, 58 cases were adverse reactions, accounting for 1.2%, of whom 4 to 9 years old were the major adverse reactions. In the first case, 20 cases of adverse reactions occurred in acyclovir injection, Rate of 34.5%, continuous use of acyclovir injection more than 2 times before the occurrence of adverse reactions in 38 cases, the incidence was 65.5%; wherein the fastest adverse reactions occurred 2 min after intravenous drip, the latest for the first 8 days; Acyclovir the most important adverse reaction is acute renal failure, followed by the skin reaction; 58 cases of children were combined with drugs, which combined two kinds of drugs, followed by a combination of drugs; 58 cases of children After stopping treatment or symptomatic treatment, 48 cases were cured, accounting for 83.8%; 9 cases improved, accounting for 15.5%; 1 case was transferred to the department of nephrology for treatment and was discharged after specialist treatment. Conclusion The clinical use of acyclovir in children with AUPI should strictly grasp the principle of using this medicine, understand the general condition of children, follow the individualized medication, pay attention to dosage and infusion rate to reduce the occurrence of adverse reactions.