儿童重症腺病毒肺炎的临床研究

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。

Clinical Characteristics of Severe Adenovirus Pneumonia in Children

Objective:To analyze the clinical characteristics of severe adenovirus pneumonia (SAP) in pediatric patients.Methods:fifty three pediatric patients with SAP were reported. All data were collected from cases who were hospitalized in the Department ofPICU GuangZhou Women and Children Medical center from January 2011 to January 2015. Blood samples were taken within 24 hrs afteradmission to ICU for blood routine test and other chemical routine test, pediatric critical illness score (PCIS) were also calculated. Thepatients were divided into survival group (n=45) and death group (n=8) based on their hospital outcomes.Results:Among 53 patients,47children were aged blow 2 years, with a male to female ratio of 3.4:1. The onset of 40 patients was in summer and autumn. 8 (15.1%)patients died. levels of LDH, AST, PaCO2, number of the lung labors involved and number of complications in death group were morethan survival group, PCIS, number of platelet, levels of albumin, PaO2, PaO2/FIO2 were less than survival group, and the difference wassignificant (P<0.05).Conclusion:SAP is a severe pneumonia with severe clinical manifestations with many complications. Levels ofLDH, AST, albumin, number of platelet, PCIS, PaCO2, PaO2, PaO2/FIO2 can predict the prognosis of critical illness patients.