河南省汝阳县婴幼儿流行性喘憋性肺炎暴发流行的病原学研究

目的：了解１９９９年１１月－２０００年１月我国河南省汝阳县婴儿流行性喘憋性肺炎（简称流喘肺炎）暴发流行的病原,方法：分别采用１２例流喘肺炎患儿的咽拭子和算咽分泌物标本进行病毒分离,间接免疫荧光检测常见的呼吸道病毒抗原以进行快速诊断,用ＲＴ－ＰＣＲ对分离到的呼吸道合孢病毒（ＲＳＶ）株进行分型,１６例用免疫荧光法检测双份血清中ＲＳＶ抗体滴度,用核苷酸序列测定对分离到的病朱进行基因分析,结果：１２例患儿咽拭子标本中（险１例污染外）４例分离到ＲＳＶ,阳性率为３６％,３例为Ａ亚型,１例为Ｂ亚型,１２例算咽分泌物脱落细胞经免疫荧光法检测９例为ＲＳＶ阳性,阳率性为７５％,未检测到其它呼吸道病毒,１６例患儿双份血清中,有１０例（６３％）恢复期血清ＲＳＶ特异性ＩgG抗体比急性期有４倍以上升高,分离株Ｆ蛋白基因的部分序列测定显示与ＲＳＶ的Ａ型型标准株有高的同源性。结论：此次婴幼儿流喘肺炎流行的病原主要为Ａ型型ＲＳＶ。     

河南省汝阳县一次流行性喘憋性肺炎的调查

流行性喘憋性肺炎 (简称流喘肺炎 )即流行性毛细支气管炎 ,曾多次在我国部分农村地区流行[1] 。 1999年 11月至2 0 0 0年 1月 ,河南省汝阳县发生了一次流喘肺炎的暴发流行 ,首都儿科研究所和汝阳县人民医院协作对这次流行进行了调查 ,报告如下。对象流行期间在汝阳县人民医院门诊和住院的患儿 ,凡符合流喘肺炎诊断标准[2 ] 均被纳为调查对象。方法1.发病人数以流行期间我院门诊日志及各乡卫生院记录完整的患儿进行统计。2 .按首都儿科研究所设计的流喘肺炎调查表 ,从患儿的基本情况、居住环境、卫生状况、家庭情况、喂养方式、过敏史、喘憋…     

静注免疫球蛋白佐治小儿流行性喘憋性肺炎临床观察

我科自2000年5月-2003年5月，采用静注免疫球蛋白佐治小儿流行性喘憋性肺炎20例，取得满意疗效，报告如下。     

我国流行性喘憋性肺炎呼吸道合胞病毒分离株F蛋白基因特征初探

目的 探讨流行性喘憋性肺炎（简称流喘肺炎）与散发肺炎呼吸道合胞病毒（ＲＳＶ）分离株Ｆ蛋白的异同。方法 采用ＰＣＲ片段直接测序及克隆测序。对１１株流喘肺炎ＲＳＶ分离株及５株散发肺炎ＲＳＶ分离株Ｆ蛋白基因序列进行了分析比较,结果 被检测流喘肺炎ＲＳＶ分离株中３６％（４／１１）的毒株其Ｆ蛋白基因３′非编码区（３′－ＮＣＲ）（第１７４１位核苷酸）存在６个核苷酸插入,而散发肺炎ＲＳＶ分离株均无此插入存在。结     

中西医结合治疗小儿喘憋性肺炎疗效观察

喘憋性肺炎主要是呼吸道合胞病毒所致，多发生于小婴儿，目前缺乏特效治疗。2003年10月～2005年6月我们采用中西医结合方法对90例典型~bJI,喘憋性肺炎（喘肺）患儿进行分组临床观察，疗效满意，报告如下。     

小儿喘憋性肺炎50例的护理体会

喘憋性肺炎是婴幼儿时期常见病，多见于偏胖患儿，其主要病原是合胞病毒，由于小儿免疫功能尚未健全和呼吸系统解剖生理特点，故发病率较高，临床上以咳嗽、喘憋、缺氧及呼吸困难为主要表现，且易合并重要生命器官功能障碍，治疗中护理工作尤为重要。现将2003年10月～2004年10月间我科收治的50例小儿喘憋性肺炎的护理体会报告如下。     

普米克令舒治疗喘憋性肺炎的临床观察

目的 观察普米克令舒雾化吸入治疗流行性喘憋性肺炎的疗效.方法 将喘憋性肺炎患儿随机分为两组,治疗组98例,在常规治疗基础上加用普米克令舒(布地奈德),对照组58例,给予常规治疗,观察临床症状:咳嗽、气急、喘息、肺部哮鸣音.对结果采用卡方检验.结果 治疗组治疗前后病情明显改善,优于对照组,两组总有效率分别为93.8%,72.4%,治疗组明显优于对照组(x2=13.877,P=0.001).结论 普米克令舒雾化吸入治疗喘憋性肺炎疗效满意.     

356例儿童支气管哮喘5年随访观察

目的 探讨农村地区儿童哮喘的转归和影响预后的因素.方法 建立住院或门诊就医的哮喘患儿档案,对356例随访档案进行整理,分析哮喘与多因素的关系.结果 哮喘停止发作2年以上239例,占67.1%;5年仍在发作的117例,占32.9%.发病诱因以下呼吸道感染最多.停止发作的相关因素中,下呼吸道感染所诱发的哮喘缓解率最高,达81.3%;肺炎支原体感染所诱发占第2位,达68.5%;有过敏性鼻炎、湿疹等特应件疾病所诱发的最低,为32.8%;长期规范化治疗与其他治疗方法在缓解率方面差异无统计学意义(P>0.05);5年后仍在发作的患儿中,个人为特应质、父母有哮喘史和嗜酸性细胞(EOS)升高是哮喘持续发作的主要相关性因素(P<0.01).结论 感染性哮喘症状持续至学龄期多数可缓解;哮喘长期发作的主要危险指标为父母有哮喘病史、个人为特应质者.     

婴儿良性癫癎38例临床跟踪随访观察

目的　观察婴儿良性癫临床发作 ,通过 6～ 15个月临床随访 ,探讨婴儿良性癫的诊断及治疗。方法　收集 2 0 0 2年 2月～ 2 0 0 3年 1月来我院神经专科门诊及病房就诊癫患儿临床资料 ,其中 38例符合婴儿良性癫诊断 ,年龄 3～ 2 4个月 ;男∶女为 17∶2 1,进行随访观察。结果　 2 7例单药治疗 ,其中 2例首次就诊未治疗 ,再发作后选择治疗 ;11例未治疗 ;2例服药 6个月后停药 ;均经 6～ 15个月随访 ,所有患儿临床发作停止 ,智能正常。结论　婴儿良性癫临床并不少见 ,预后好 ;对不愿治疗患儿应严密观察     

婴儿良性癫痫38例临床跟踪随访观察

目的 观察婴儿良性癫痫临床发作，通过6～15个月临床随访，探讨婴儿良性癫痫的诊断及治疗。方法 收集2002年2月～2003年1月来我院神经专科门诊及病房就诊癫痫患儿临床资料，其中38例符合婴儿良性癫痫诊断，年龄3～24个月；男：女为17：21，进行随访观察。结果 27例单药治疗，其中2例首次就诊未治疗，再发作后选择治疗；11例未治疗；2例服药6个月后停药；均经6～15个月随访，所有患儿临床发作停止，智能正常，结论 婴儿良性癫痫临床并不少见，预后好；对不愿治疗患儿应严密观察。     

A prospective 12-year follow-up study of children with wheezy bronchitis

Eighty children with wheezy bronchitis were followed prospectively for 12 years. At the end of the follow-up period only 22 (28%) still had symptoms of asthma. Forty-three children (54%) had ceased to wheeze before the age of 3 years, four children between 3 and 7 years of age and 11 children between 7 and 11 years of age. Of the 22 children who still had asthma, all but one were much improved, although 70% of them noticed asthmatic symptoms during exercise. Heredity for asthma/wheezing, allergy, the occurrence of eczema, and onset of wheezing after 18 months of age were associated with an increased risk of persistent asthma. Allergy had developed in 59% of the children with persistent asthma and in 10% of those who had stopped wheezing. Serum IgE was above the mean +1 SD in 45% and above the mean +2 SD in 24% of the children at the end of the 12-year follow-up. A serum IgE above the mean +2 SD was found in 8 of 13 children with asthma combined with proven allergy, but only in 1 of 9 children with asthma without allergy. Surprisingly, 8 of 48 children who had stopped wheezing and had no clinical allergy had as high IgE levels as the children with asthma and allergy, which reduced the allergy predictive value of a high serum IgE to 36%. Some of these high IgE levels seemed to be a family trait.     

Five-year follow-up of Vietnamese refugee children in the United States

The purpose of this study was to investigate the present physical, mental, and psycho-social health of Vietnamese refugee children. Questionnaires were sent or given to adoptive families, foster families, and Vietnamese children living in the United States with their family units. Otitis media, respiratory ailments, and varicella constituted a large number of their initial medical problems. Severe nightmares and temper tantrums occurred frequently during their first year. It was found that the children's health and emotional problems improved markedly after the first year. Despite stormy pasts, present social and school problems are minimal, and some children appear to be high achievers. Most of the Vietnamese children, especially those who were adopted, are doing much better than we anticipated. Advance preparation and guidance given by the involved agencies appear to be of significance in achieving these excellent results.     

毛细支气管炎患儿血浆降钙素基因相关肽、血管活性肠肽的测定

毛细支气管炎(简称毛支炎)是婴幼儿常见的下呼吸道感染性疾病,由于其发病机制尚不十分清楚,目前治疗上只能以对症处理为主。临床研究发现,有20%~50%毛支炎患儿以后发展为小儿哮喘。近年来研究证实降钙素基因相关肽(calcitonin gene-related peptide,CGRP)、血管活性肠肽(vasoactive intestinal peptide,VIP)作为非肾上腺素能非胆碱能(nonadrenergic noncholinergic,NANC)神经释放的神经递质,在哮喘的气道慢性炎症和气道高反应性形成过程中起重要作用[1],而毛支炎与支气管哮喘的发病关系密切,因此推测它们在毛支炎的发病机制中也可能起…     

Five-year follow-up of intermittent distracting rod correction in congenital scoliosis.

Severe progressive curve deformities in children's congenital scoliosis often require an early operative intervention. As spinal fusion interferes with longitudinal growth, a "growth enabling" operative device may represent an alternative method to delay a progressive curve deformity until an eventual operative intervention can be carried out. We report on the five-year follow-up of a seven-year-old girl who presented at our clinic with severe congenital scoliosis of 62 degrees with a unilateral unsegmented bar between T7 and T12 and an anomaly of segmentation between L2 and L4. An intermittent distracting rod was implanted with transpedicular fixation from T3/T5 to L3/L4. The correction was obtained by distraction of the mobile segments and also by hemiepiphyseodesis between L2 and L4. The rod's longitudinal extension could be distracted using a special thread. Three successive operations to obtain a minimal access to the thread were necessary to achieve a correction to an angle of 30 degrees with a total rod distraction of 4.5 cm.     

氧驱动雾化吸入氨溴索治疗毛细支气管炎的临床分析

目的 探讨氧驱动雾化吸入氨溴索治疗毛细支气管炎的疗效.方法 2005年10月至2007年12月,将上海市第一人民医院松江分院收治的108例毛细支气管炎患儿分为A、B、C三组.三组均采用常规治疗.A组加用氧驱动雾化吸入氨溴索,每日2次.B组加用静脉滴注氨溴索,分2次.C组加用口服氨溴索,每日2次.三组治疗均连用5 d.对三组临床症状、肺部体征、住院天数及总有效率进行对照评价.结果 A组治愈率明显提高,咳嗽喘憋.哮鸣音湿啰音消失及住院时间明显缩短,与B、C两组比较差异有显著性(P<0.01).结论 氧驱动雾化吸入氨溴索治疗毛细支气管炎,可缩短病程,提高治愈率,疗效确切,使用安全.