摘要
目的总结分析儿童重症肺炎的临床特点及预后分析,为指导临床针对性经验治疗提供一定参考。方法回顾性分析2016年10月-2018年9月佛山市第一人民医院收治的204例重症肺炎患儿临床资料,统计患儿一般情况(年龄、性别)、病情程度、是否存在基础病、并发症发生情况、治疗情况(治疗前后入院临床严重程度评分、血常规、降钙素原(PCT)值、血气分析)、预后情况,分析患儿预后不良的影响因素。结果本组204例重症肺炎患儿中男129例(63.24%),女75例(36.76%);中位年龄6(2~15)月。入院临床严重程度评分(CSSA)为(3.73±0.52)分。67例(32.84%)存在基础病,126例(61.76%)患儿存在并发症。治疗后入院临床严重程度评分、白细胞计数(WBC)、中性粒细胞比值(N%)、高敏C反应蛋白(hs-CRP)、动脉二氧化碳分压(PaCO2)、PCT水平均较治疗前降低,动脉氧分压(PaO2)、血氧饱和度(SaO2)水平均较治疗前提高,差异有统计学意义(P<0.05)。预后情况:治愈92例(45.10%),好转89例(43.63%),未愈23例(11.27%)。单因素分析显示,预后不良组存在基础病与并发症人数比例均高于预后良好组,差异有统计学意义(P<0.05);经Logistic多因素回归分析可知,存在基础病、存在并发症为重症肺炎患儿预后不良的主要危险因素(P均<0.05)。结论重症肺炎好发于≤1岁婴儿,常存在基础病及并发症。血常规、血气分析、PCT检查常存在异常。患儿预后不良的主要影响因素为存在基础病及并发症。
Objective To analyze the clinical characteristics and prognosis of severe pneumonia(SP)in pediatrics thereby provide a basic reference for empirical treatment of SP.Methods From October 2016 to September 2018,clinical data of204 cases of pediatric SP enrolled in the First People’s Hospital of Foshan were retrospectively analyzed.General conditions(age,gender),severity of illness,background diseases,complications,treatment(clinical severity score pre and post treatment,evolution of blood routine test,procalcitonin(PCT),ABG and imaging changes),hospitalization and prognosis were collected and analyzed.Results 129 male(63.24%)and 75 female(36.76%),with mean age of 6(2-15)months.The clinical severity score at admission(CSSA)was(3.73±0.52)points.67 cases(32.84%)had background diseases,and 126 cases(61.76%)had complications.After treatment,the clinical severity score,white blood cell count(WBC),neutrophil ratio(N%),hypersensitive C-reactive protein(hs-CRP),arterial partial pressure of carbon dioxide(PaCO2),and PCT levels were lower than before treatment,and arterial partial pressure of oxygen(PaO2),blood oxygen saturation(SaO2)levels were higher than before treatment,the differences were statistically significant(P<0.05).Prognosis:92 cases(45.10%)were cured,89 cases(43.63%)improved,and 23 cases(11.27%)did not heal.Univariate analysis showed that the proportion of people with underlying diseases and complications in the poor prognosis group was higher than that in the good prognosis group,and the difference was statistically significant(P<0.05);logistic multivariate regression analysis shewed that the underlying diseases and complications were the main risk factors for poor prognosis in children with SP(all P<0.05).Conclusions Severe pneumonia usually occurs in infants less than 1 year old,and there are often underlying diseases and complications.There are often abnormalities in blood routine,blood gas analysis,and PCT examination.The main influencing factors for the poor prognosis of children are the existence of underlying diseases and complications.
作者
黄葆莹
蒋苏华
陈晓倩
梁永祺
甄劲争
HUANG Bao-ying;JIANG Su-hua;CHEN Xiao-qian;LIANG Yong-qi;ZHEN Jing-zheng(The First People 5 Hospital of Foshan,Foshan,Guangdong 528000,China)
出处
《热带医学杂志》
CAS
2020年第10期1326-1329,共4页
Journal of Tropical Medicine
基金
佛山市医学科技攻关项目(2018AB003201)。
关键词
重症肺炎
发病年龄
病情程度
基础病
预后
Severe pneumonia
Disease severity
Background diseases
Prognosis
