目的 探討呋喃妥因聯(lián)合頭孢甲肟治療兒童復(fù)發(fā)性尿路感染的臨床療效。方法 選取2018年8月-2020年8月在沈陽(yáng)市兒童醫(yī)院治療的120例復(fù)發(fā)性尿路感染患兒，隨機(jī)分為對(duì)照組（60例）和治療組（60例）。對(duì)照組患兒靜脈輸注注射用鹽酸頭孢甲肟，每次2 g溶于生理鹽水200 mL，2次/d。治療組患兒在對(duì)照組的基礎(chǔ)上口服呋喃妥因腸溶片，每天7 mg/kg，3次/d。兩組患兒連續(xù)用藥5 d。觀察兩組患兒臨床療效，比較治療前后兩組患兒臨床癥狀好轉(zhuǎn)時(shí)間，尿液紅細(xì)胞、白細(xì)胞、鱗狀上皮細(xì)胞和細(xì)菌指標(biāo)，尿液白細(xì)胞介素6（IL-6）、白細(xì)胞介素8（IL-8）、肝素結(jié)合蛋白（HBP）、中性粒細(xì)胞明膠酶相關(guān)脂質(zhì)運(yùn)載蛋白（NGAL）水平。結(jié)果 治療后，治療組臨床總有效率明顯高于對(duì)照組（98.33%vs 83.33%，P<0.05）。治療后，治療組患兒臨床癥狀好轉(zhuǎn)時(shí)間明顯早于對(duì)照組（P<0.05）。治療后，兩組患兒尿液紅細(xì)胞、白細(xì)胞、鱗狀上皮細(xì)胞、細(xì)菌水平均明顯降低（P<0.05），且治療組明顯低于對(duì)照組（P<0.05）。治療后，兩組患兒尿液中IL-6、IL-8、HBP、NGAL水平明顯下降（P<0.05），且治療組均明顯低于對(duì)照組（P<0.05）。結(jié)論 呋喃妥因腸溶片與注射用鹽酸頭孢甲肟聯(lián)合治療兒童復(fù)發(fā)性尿路感染效果顯著，臨床癥狀好轉(zhuǎn)迅速，能有效抑制細(xì)菌增殖，降低炎性反應(yīng)，治療和預(yù)防尿路感染。

Objective To investigate the efficacy of nitrofurantoin combined with cefmenoxime in treatment of recurrent urinary tract infections in children. Methods Children (120 cases) with recurrent urinary tract infections in Shenyang Children's Hospital from August 2018 to August 2020 were randomly divided into control (60 cases) and treatment (60 cases) groups. Children in the control group were iv administered with Cefmenoxime Hydrochloride for injection, 2 g dissolved in normal saline 200 mL once, twice daily. Children in the treatment group were po administered with Nitrofurantoin Enteric-coated Tablets, 7 mg/(kg·d), three times daily. Children in two groups were treated for 1 month. After treatment, the clinical efficacy was evaluated, the improvement of clinical symptoms, plasma fibrinogen, the improvement time of clinical symptoms, the indexes of red blood cells, white blood cells, squamous epithelial cells and bacteria in urine, the levels of IL-6, IL-8, HBP, and NGAL in urine in two groups before and after treatment were compared. Results After treatment, the clinical effective rate in the treatment group was significantly higher than that of the control group (98.33% vs 83.33%, P<0.05). After treatment, the improvement time of clinical symptoms in the treatment group was significantly earlier than that in the control group (P<0.05). After treatment, the indexes of red blood cells, white blood cells, squamous epithelial cells, and bacteria in urine of the two groups were significantly decreased (P<0.05), and these indexes in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the indexes levels of IL-6, IL-8, HBP, and NGAL in urine of the two groups were significantly decreased, and which in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion The combination of Nitrofurantoin Enteric-coated Tablets and Cefmenoxime Hydrochloride for injection has a significant therapeutic effect, and which can rapidly improve clinical symptoms, effectively inhibit bacterial proliferation, reduce inflammatory reaction, treat and prevent urinary tract infection.

R983