泰安市中心医院儿童大叶肺炎病原学特点及临床分析(1)
摘 要：目的 通过分析儿童大叶肺炎的病原学特点、临床特征、治疗效果及预后指导临床工作。方法 对2017年1月～12月入住泰安市中心医院儿内科的147例大叶肺炎患儿病原学特点、临床特征及诊疗过程进行分析。结果 ①男性102例，女性45例，年龄4个月～13岁，平均年龄(3.47±4.17)岁，约占同期肺炎患儿的7.41%；全部病例均有咳嗽，伴发热占91.83%；②存在合并症共有27例，占18.37%，其中胸腔积液19例，胸膜炎24例，气胸1例；③CRP、白细胞计数升高各占33.33%、23.81%；肺炎支原体抗体阳性占78.91%，血白细胞内EB病毒-DNA阳性占55.10%；④治疗后发热平均持续时间(4.60±1.57)d，复查胸部CT 123例完全吸收(83.67%)，平均住院(9.40±2.17)d。结论 儿童大叶肺炎以学龄前及学龄期儿童为主，支原体感染占绝大多数，部分患儿合并细菌、EB病毒感染；症状不典型，多以发热为首发症状，体征不明显，并发症多，经正规抗感染治疗，患儿绝大多数均能痊愈。
关键词：大叶肺炎；支原体；EB病毒
, 百拇医药
中图分类号：R543 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.22.038
文章编号：1006-1959(2018)22-0133-03
Pathogenic and Clinical Analysis of Children's Lobar Pneumonia in Central Hospital of
Tai'an City
WANG Zhao-hui，LUO Rong-hua，WANG Xu-dong，SHEN Jing-jing，SUN Yan
(Department of Pediatrics，Tai'an Central Hospital，Tai'an 271000，Shandong，China)
, http://www.100md.com
Abstract：Objective To guide clinical work by analyzing the etiology， clinical features， treatment effects and prognosis of children with lobar pneumonia. Methods The pathogenic characteristics， clinical features and diagnosis and treatment of 147 children with lobar pneumonia admitted to the Department of Pediatrics of Tai'an Central Hospital from January to December 2017 were analyzed. Results ①Male 102 cases， female 45 cases， aged 4 months to 13 years， mean age (3.47±4.17) years old， accounting for 7.41% of children with pneumonia in the same period； all cases have cough， with fever accounted for 91.83%；②There were 27 cases of comorbidities， accounting for 18.37%， including 19 cases of pleural effusion， 24 cases of pleurisy， 1 case of pneumothorax； ③CRP， white blood cell count increased by 33.33%， 23.81%； Mycoplasma pneumoniae antibody accounted for 78.91%， blood Epstein-Barr virus-DNA positive in leukocytes accounted for 55.10%； ④Mean fever duration after treatment (4.60±1.57)d， 123 cases of chest CT were completely absorbed (83.67%)， and the average hospital stay (9.40±2.17)d. Conclusion Children with lobar pneumonia are mainly preschool and school-age children. Mycoplasma infection accounts for the majority. Some children have bacterial and EB virus infection. The symptoms are atypical. Most of them have fever as the first symptom， the signs are not obvious， and the complications are many. After regular anti-infective treatment， most of the children can be cured.
Key words：Lobar pneumonia；Mycoplasma；Epstein-Barr virus
大葉肺炎(lobar pneumonia)主要是由肺炎链球菌引起，病变累及一个肺段以上肺组织，以肺泡内弥漫性纤维素渗出为主的急性炎症。典型临床症状有突然寒战、高热、咳嗽、胸痛、咳铁锈色痰。血白细胞计数增高；典型的X线表现为肺段、叶实变。但近年来，儿童大叶肺炎表现多不典型，常以发热为唯一起病表现，后期出现咳嗽、咳痰等症状，且发病率有增高趋势[1，2]，而病原也不以肺炎链球菌为主，故儿童大叶肺炎的诊断及治疗有了新的特点。现就泰安市中心医院儿科2017年1月～12月收治的147例儿童大叶肺炎的病原学特点及临床特征和治疗进行回顾性分析。, http://www.100md.com(王兆辉 罗荣华 王绪栋)
关键词：大叶肺炎；支原体；EB病毒
, 百拇医药
中图分类号：R543 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.22.038
文章编号：1006-1959(2018)22-0133-03
Pathogenic and Clinical Analysis of Children's Lobar Pneumonia in Central Hospital of
Tai'an City
WANG Zhao-hui，LUO Rong-hua，WANG Xu-dong，SHEN Jing-jing，SUN Yan
(Department of Pediatrics，Tai'an Central Hospital，Tai'an 271000，Shandong，China)
, http://www.100md.com
Abstract：Objective To guide clinical work by analyzing the etiology， clinical features， treatment effects and prognosis of children with lobar pneumonia. Methods The pathogenic characteristics， clinical features and diagnosis and treatment of 147 children with lobar pneumonia admitted to the Department of Pediatrics of Tai'an Central Hospital from January to December 2017 were analyzed. Results ①Male 102 cases， female 45 cases， aged 4 months to 13 years， mean age (3.47±4.17) years old， accounting for 7.41% of children with pneumonia in the same period； all cases have cough， with fever accounted for 91.83%；②There were 27 cases of comorbidities， accounting for 18.37%， including 19 cases of pleural effusion， 24 cases of pleurisy， 1 case of pneumothorax； ③CRP， white blood cell count increased by 33.33%， 23.81%； Mycoplasma pneumoniae antibody accounted for 78.91%， blood Epstein-Barr virus-DNA positive in leukocytes accounted for 55.10%； ④Mean fever duration after treatment (4.60±1.57)d， 123 cases of chest CT were completely absorbed (83.67%)， and the average hospital stay (9.40±2.17)d. Conclusion Children with lobar pneumonia are mainly preschool and school-age children. Mycoplasma infection accounts for the majority. Some children have bacterial and EB virus infection. The symptoms are atypical. Most of them have fever as the first symptom， the signs are not obvious， and the complications are many. After regular anti-infective treatment， most of the children can be cured.
Key words：Lobar pneumonia；Mycoplasma；Epstein-Barr virus
大葉肺炎(lobar pneumonia)主要是由肺炎链球菌引起，病变累及一个肺段以上肺组织，以肺泡内弥漫性纤维素渗出为主的急性炎症。典型临床症状有突然寒战、高热、咳嗽、胸痛、咳铁锈色痰。血白细胞计数增高；典型的X线表现为肺段、叶实变。但近年来，儿童大叶肺炎表现多不典型，常以发热为唯一起病表现，后期出现咳嗽、咳痰等症状，且发病率有增高趋势[1，2]，而病原也不以肺炎链球菌为主，故儿童大叶肺炎的诊断及治疗有了新的特点。现就泰安市中心医院儿科2017年1月～12月收治的147例儿童大叶肺炎的病原学特点及临床特征和治疗进行回顾性分析。, http://www.100md.com(王兆辉 罗荣华 王绪栋)