本文關(guān)鍵詞：小兒重癥肺炎193例臨床特征觀察　出處：《安徽醫(yī)科大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 重癥肺炎 臨床特點(diǎn) 病原學(xué) 影像學(xué) 小兒

【摘要】：目的總結(jié)小兒重癥肺炎的臨床特點(diǎn),以提高診療水平,改善患兒轉(zhuǎn)歸。方法回顧性分析10年住院重癥肺炎患兒的臨床表現(xiàn)及體征、基礎(chǔ)疾病、病原學(xué)檢查、影像學(xué),并與同期住院的120例小兒普通肺炎進(jìn)行對(duì)比分析。結(jié)果193例重癥肺炎患兒中男130例,女63例,男女比例2：1,其中0～3歲的患兒115例(60%),冬春季為發(fā)病高峰,為125例,占發(fā)病總數(shù)65%；193例患兒均有發(fā)熱,體溫在39℃～41℃之間98例,占50.8%,患兒入院時(shí)有呼吸系統(tǒng)癥狀,包括咳嗽183例(94.8%),喘息113例(58.5%),患兒均有呼吸困難、氣促或紫紺,肺部濕Up音105例(54.3%),呼吸功能不全或呼吸衰竭152例(78.7%),急性呼吸窘迫綜合征12例(6.2%),心力衰竭163例(84.5%),腹脹67例(34.7%),23例(14.1%)需要機(jī)械通氣。肺炎支原體抗體感染,陽性91例(47.2%),行血清病毒抗體及呼吸道病毒抗原檢測(cè),檢測(cè)出陽性抗體20例(10.4%),體液培養(yǎng)(痰培養(yǎng)、胸水培養(yǎng)及血培養(yǎng)),共培養(yǎng)出陽性菌株31例(16.1%),其中銅綠假單胞菌7例(3.6%),大腸埃希菌6例(3.1%),肺炎克雷伯桿菌6例(3.1%),陰溝桿菌5例(2.6%),肺炎鏈球菌3例(1.6%),草綠色鏈球菌2例(1.0%),溶血性葡萄球菌1例(0.5%),放射土壤桿菌1例(0.5%),真菌為假絲酵母菌2例(1.0%)。影像學(xué)結(jié)果,106例(54.9%)均呈肺葉或節(jié)段性大片狀密度增高影或肺實(shí)質(zhì)炎癥浸潤(rùn)性病變。表現(xiàn)為肺間質(zhì)炎性病變(如肺紋理增多、模糊、內(nèi)中帶條絮影等)占87例(33.2%),有胸腔積液30例(15.5%),肺不張18例(9.3%),膿胸16例(8.3%)。結(jié)論重癥肺炎臨床表現(xiàn)重,易出現(xiàn)心衰、呼衰等合并癥,臨床疑診重癥肺炎時(shí)盡早完善病原學(xué)及胸部影像學(xué)檢查，早診斷,早治療。
[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，

本文編號(hào)：1381811