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目的:分析儿童重症腺病毒肺炎(SAP)的临床特点。方法:选择2011年01月至2015年01月广州市妇女儿童医疗中心重症监护室收治的被诊断为SAP的患儿53例。患儿入监护室后24 h内采集静脉血,检测血常规、血气、生化等指标,并结合病史与常规生化等检测指标同步给出PCIS评分。根据患儿的转归,将所有患儿分为生存组和死亡组进行比较分析。结果:53例重症腺病毒肺炎患儿,男女比例为3.4:1,2岁以下发病者48例,夏秋季发病共40例。死亡组患儿共8例(15.1%),其LDH、AST、Pa CO2水平、肺叶受累数量、并发症种类较存活组患儿明显升高,危重症评分(PCIS)、血小板、白蛋白、Pa O2水平、Pa O2/FIO2比值均较生存组显著降低(P均<0.05)。结论:儿童SAP炎症反应重,常伴肺内外各种损害,早期的LDH、AST、白蛋白水平、血小板数量、Pa O2、Pa CO2、Pa O2/Fi O2及PCIS评分是疾病预后的早期预测指标,有助于临床医生对重症腺病毒肺炎患儿病情危重程度尽早作出正确判断。
Objective: To analyze the clinical features of children with severe adenovirus pneumonia (SAP). Methods: From January 2011 to January 2015, 53 cases of children diagnosed with SAP in Guangzhou Women and Children’s Medical Center Intensive Care Unit were selected. Venous blood was collected within 24 hours after admission to the care unit. Blood samples, blood gas, biochemical indexes and other indicators were collected. The PCIS score was given in combination with medical history and routine biochemical indexes. According to the outcome of children, all children were divided into survival group and death group for comparative analysis. Results: 53 cases of severe adenovirus pneumonia in children, male to female ratio of 3.4: the incidence of 1,2-year-old in 48 cases, a total of 40 cases of summer and autumn onset. There were 8 cases (15.1%) in the death group. The levels of LDH, AST, PaCO 2, the number of pulmonary lobes and complications were significantly higher in survivors than in survivors. The scores of critical illness score (PCIS), platelet, albumin, O2 levels, Pa O2 / FIO2 ratio were significantly lower than the survival group (P all <0.05). CONCLUSIONS: Inflammatory reaction in children with severe SAP often accompanied by various lung and lung damage, early LDH, AST, albumin levels, platelet count, Pa O2, Pa CO2, Pa O2 / Fi O2 and PCIS score are early predictors of disease prognosis , To help clinicians to make the correct judgment as soon as possible on the severity of illness in children with severe adenovirus pneumonia.