儿童腺病毒肺炎58例临床分析(1)
【摘要】 目的 探討儿童腺病毒肺炎的临床特点，提高对该病诊治的认识。方法 选取确诊为腺病毒肺炎的58例患儿为研究对象，统计分析其临床表现、并发症、病原学检查、胸部影像学表现、纤维支气管镜表现、治疗及预后等资料。结果 58例中男38例、女20例，男女比例1.9∶1，年龄(31.40±9.45)个月，其中6个月～ 3岁者较多。58例均急性起病，均有发热、咳嗽，热程(9.25±3.57)d，并发症中呼吸衰竭(29.3%)、心肌损害(19.0%)所占百分率较高。58例血清腺病毒IgM均为阳性，27例(46.6%)合并细菌感染，10例(17.2%)合并有其他呼吸道病毒感染。58例胸部CT主要表现为双肺实变、渗出;20例纤维支气管镜检查结果主要表现为气管内膜炎症。经过抗病毒及对症支持等治疗后，治愈49例、好转8例、放弃治疗1例，无死亡病例。随访3个月，58例中6例(10.3%)出现闭塞性细支气管炎，其他患儿均正常。结论 儿童腺病毒肺炎是婴幼儿肺炎的严重类型之一，起病急、热程长，常并发多系统损害，易伴多种混合感染。临床医师应结合患儿病情及临床表现，早识别、早治疗，给予合理综合治疗以降低病死率、致残率。
【关键词】 儿童;腺病毒;肺炎;临床特点
Clinical analysis of 58 children with adenovirus pneumonia Xu Weihua， Tian Keyin， Li Xiaoshuang.Emergency Department， Anhui Provincial Children’s Hospital， Hefei 230051， China
【Abstract】 Objective To investigate the clinical characteristics of 58 cases of adenovirus pneumonia， aiming to improve the diagnosis and treatment of this disease. Methods Fifty-eight children diagnosed with adenovirus pneumonia were enrolled in this study. The clinical manifestations， complications， etiology， chest imaging manifestations， fibrobronchoscopy， treatment and prognosis were statistically analyzed. Results Among 58 cases， 38 were male and 20 were female. The ratio of male and female was 1.9∶1， aged (31.40±9.45) months on average. A majority of them were aged from 6 months to 3 years old. All patients had acute onset and presented with fever and cough. The average duration of fever was (9.25±3.57) d. Among all complications， the proportion of heart failure was 29.3% and 19.0% for myocardial damage. Serum adenovirus-specific IgM was positive in 58 cases. Twenty-seven patients (46.6%) were complicated with bacterial infection and 10 patients (17.2%) were complicated with other respiratory viral infections. The main manifestations of chest CT scan included consolidation and exudation of bilateral lungs in 58 patients， and endotracheal inflammation by fibrobronchoscopy in 20 patients. After antiviral and other symptomatic supportive therapies， 49 cases were healed， 8 patients were improved， 1 case withdrew from treatment and no death occurred. During 3-month follow-up， 6 (10.3%) of 58 patients developed bronchiolitis obliterans and other children were normal. Conclusions Pediatric adenovirus pneumonia is one of the most severe types of infantile pneumonia， which is characterized by acute onset， long duration of fever， complicated with multiple system damage and is prone to a variety of other mixed infections. Clinicians should deliver early diagnosis and treatment according to the disease conditions and clinical manifestations of the pediatric patients. In addition， reasonable comprehensive treatment can be given to lower the mortality and disability rates., 百拇医药(徐卫华?田克印?李小双)
【关键词】 儿童;腺病毒;肺炎;临床特点
Clinical analysis of 58 children with adenovirus pneumonia Xu Weihua， Tian Keyin， Li Xiaoshuang.Emergency Department， Anhui Provincial Children’s Hospital， Hefei 230051， China
【Abstract】 Objective To investigate the clinical characteristics of 58 cases of adenovirus pneumonia， aiming to improve the diagnosis and treatment of this disease. Methods Fifty-eight children diagnosed with adenovirus pneumonia were enrolled in this study. The clinical manifestations， complications， etiology， chest imaging manifestations， fibrobronchoscopy， treatment and prognosis were statistically analyzed. Results Among 58 cases， 38 were male and 20 were female. The ratio of male and female was 1.9∶1， aged (31.40±9.45) months on average. A majority of them were aged from 6 months to 3 years old. All patients had acute onset and presented with fever and cough. The average duration of fever was (9.25±3.57) d. Among all complications， the proportion of heart failure was 29.3% and 19.0% for myocardial damage. Serum adenovirus-specific IgM was positive in 58 cases. Twenty-seven patients (46.6%) were complicated with bacterial infection and 10 patients (17.2%) were complicated with other respiratory viral infections. The main manifestations of chest CT scan included consolidation and exudation of bilateral lungs in 58 patients， and endotracheal inflammation by fibrobronchoscopy in 20 patients. After antiviral and other symptomatic supportive therapies， 49 cases were healed， 8 patients were improved， 1 case withdrew from treatment and no death occurred. During 3-month follow-up， 6 (10.3%) of 58 patients developed bronchiolitis obliterans and other children were normal. Conclusions Pediatric adenovirus pneumonia is one of the most severe types of infantile pneumonia， which is characterized by acute onset， long duration of fever， complicated with multiple system damage and is prone to a variety of other mixed infections. Clinicians should deliver early diagnosis and treatment according to the disease conditions and clinical manifestations of the pediatric patients. In addition， reasonable comprehensive treatment can be given to lower the mortality and disability rates., 百拇医药(徐卫华?田克印?李小双)
参见：首页 > 医疗版 > 疾病专题 > 呼吸内科 > 肺炎