小儿重症肺炎193例临床特征观察

发布时间：2018-01-05 05:37

  本文关键词：小儿重症肺炎193例临床特征观察　出处：《安徽医科大学》2016年硕士论文　论文类型：学位论文

  更多相关文章： 重症肺炎 临床特点 病原学 影像学 小儿

【摘要】：目的总结小儿重症肺炎的临床特点,以提高诊疗水平,改善患儿转归。方法回顾性分析10年住院重症肺炎患儿的临床表现及体征、基础疾病、病原学检查、影像学,并与同期住院的120例小儿普通肺炎进行对比分析。结果193例重症肺炎患儿中男130例,女63例,男女比例2：1,其中0～3岁的患儿115例(60%),冬春季为发病高峰,为125例,占发病总数65%；193例患儿均有发热,体温在39℃～41℃之间98例,占50.8%,患儿入院时有呼吸系统症状,包括咳嗽183例(94.8%),喘息113例(58.5%),患儿均有呼吸困难、气促或紫绀,肺部湿Up音105例(54.3%),呼吸功能不全或呼吸衰竭152例(78.7%),急性呼吸窘迫综合征12例(6.2%),心力衰竭163例(84.5%),腹胀67例(34.7%),23例(14.1%)需要机械通气。肺炎支原体抗体感染,阳性91例(47.2%),行血清病毒抗体及呼吸道病毒抗原检测,检测出阳性抗体20例(10.4%),体液培养(痰培养、胸水培养及血培养),共培养出阳性菌株31例(16.1%),其中铜绿假单胞菌7例(3.6%),大肠埃希菌6例(3.1%),肺炎克雷伯杆菌6例(3.1%),阴沟杆菌5例(2.6%),肺炎链球菌3例(1.6%),草绿色链球菌2例(1.0%),溶血性葡萄球菌1例(0.5%),放射土壤杆菌1例(0.5%),真菌为假丝酵母菌2例(1.0%)。影像学结果,106例(54.9%)均呈肺叶或节段性大片状密度增高影或肺实质炎症浸润性病变。表现为肺间质炎性病变(如肺纹理增多、模糊、内中带条絮影等)占87例(33.2%),有胸腔积液30例(15.5%),肺不张18例(9.3%),脓胸16例(8.3%)。结论重症肺炎临床表现重,易出现心衰、呼衰等合并症,临床疑诊重症肺炎时尽早完善病原学及胸部影像学检查，早诊断,早治疗。
[Abstract]:Objective to summarize the clinical features of severe pneumonia in children in order to improve the level of diagnosis and treatment and to improve the outcome of children. Methods the clinical manifestations and signs, basic diseases and etiology of children with severe pneumonia in hospital for 10 years were analyzed retrospectively. Results among 193 cases of severe pneumonia, 130 cases were male, 63 cases were female, the ratio of male to female was 2: 1. Among them, 115 cases of children aged 0 to 3 years old had the highest incidence in winter and spring (125 cases), accounting for 65% of the total incidence. All the 193 cases had fever, 98 cases had body temperature between 39 鈩，

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