急性下呼吸道感染患儿人冠状病毒感染状况研究

发布时间：2018-06-03 20:58

  本文选题：急性下呼吸道感染 + 儿童　； 参考：《中华医院感染学杂志》2017年12期

【摘要】：目的探讨住院急性下呼吸道感染患儿人冠状病毒感染状况,为临床防治提供理论依据。方法选择2013年1月-2015年12月医院就诊急性下呼吸道感染的患儿3140例,36例单纯人冠状病毒(HCoV)感染患儿为研究组,在其余3012例非人冠状病毒感染患儿中选择与研究组一般资料无差异的患儿60例为对照组;采集所有患儿入院1d内的鼻咽吸取物或者鼻咽拭子标本1份,并于72小时内送检;对3140例下呼吸道感染患儿中人冠状病毒感染情况及临床特征进行分析。结果 3140例患儿共检出流感病毒224例,呼吸道合胞病毒652例,多瘤病毒KI173例,多瘤病毒WU 192例,人偏肺病毒257例,人冠状病毒128例,副流感病毒572例,腺病毒358例,鼻病毒584例其中人冠状病毒感染阳性率为4.08%,单纯感染患儿36例,其中HCoV-HKUI、HCoV-OC43、HCoV-229E、HCoV-NL63、HCoV-EMC、SARS-CoV分别为6例,12例、6例、6例、3例、3例;研究组患儿咳嗽、呼吸衰竭、腹泻、发热、喘息和低氧血症比例显著高于对照组(P0.05);27例患儿出现吸气相湿Up音和双肺呼气相喘鸣音,30例患儿胸部影像学表现支气管炎,3例为喉气管炎,3例为毛细支气管炎,9例患儿表现出肺部实变影,24例患儿表现出过度通气现象。结论下呼吸道感染患儿人冠状病毒感染,咳嗽为首发症状,同时伴随呼吸急促、喘息,多数伴随发热,肺部听诊表现呼气相高调喘鸣声和细湿罗音,部分患儿伴有腹泻症状。对于临床诊断为以上症状的儿童,应该积极采取措施,对患者感染病毒进行检测,进行针对性治疗。
[Abstract]:Objective to investigate the status of human coronavirus infection in hospitalized children with acute lower respiratory tract infection and to provide theoretical basis for clinical prevention and treatment. Methods A total of 3140 children with acute lower respiratory tract infection from January 2013 to December 2015 were selected as study group. 36 children with simple human coronavirus HCoV infection were selected as the study group. Among the other 3012 cases of non-human coronavirus infection, 60 cases were selected as control group, and 1 sample of nasopharynx drains or nasopharyngeal swabs was collected from all the children within one day of admission and submitted to examination within 72 hours. The clinical features of human coronavirus infection in 3140 children with lower respiratory tract infection were analyzed. Results A total of 224 cases of influenza virus, 652 cases of respiratory syncytial virus, 2 cases of polytumour virus KI173, 192 cases of polytumour virus, 257 cases of human metapulmonary virus, 128 cases of human coronavirus, 572 cases of parainfluenza virus and 358 cases of adenovirus were detected in 3140 children. The positive rate of human coronavirus infection was 4.08 in 584 cases of rhinovirus and 36 cases of infantile infection, including HCoV-HKUIHCoV-OC43, HCoV-229ECoV-NL63, HCoV-NL63, HCoV-EMCSARS-CoV, 6 cases of SARS-CoV, 6 cases of 6 cases of SARS-CoV infection, 3 cases of cough, respiratory failure, diarrhea, fever and fever in study group. The rates of wheezing and hypoxemia were significantly higher than those in the control group (27 cases) with inspiratory wet up and 30 cases with bronchitis and bronchiolitis. 3 cases were laryngotracheitis, 3 cases were bronchiolitis and 9 cases were capillary bronchitis. 24 children showed pulmonary hyperventilation. Conclusion in children with lower respiratory tract infection, cough is the first symptom, accompanied by shortness of breath, wheezing, and fever. The lung auscultation shows high breath tone and thin moist rale, and some children have diarrhea symptoms. For children clinically diagnosed with these symptoms, we should take active measures to detect the infected virus and carry out targeted treatment.
【作者单位】： 宁波市妇女儿童医院儿内科;
【分类号】：R725.6
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本文编号：1974156