小儿流行性出血热的诊断与治疗：附145例临床分析

流行性出血热是由汉坦病毒(Hantavirus,HV)中的一些病毒引起的急性传染病称为肾综合征出血热(HFRS)。该病主要患者为20～40岁青壮年,小儿病例较少,国内报道小儿病例不多。现将我院22年来积累的145例作一临床分析。 一、一般资料 (1)1974～1995年22年中以     

小儿流行性出血热41例临床分析(摘要)

我们两院自1979年1月～1986年3月共收治小儿流行性出血热(简称出血热)41例,就其临床特点与成人进行了比较,现分析如下。一、一般资料:41例小儿出血热占同期出血热总病例数1551例的2.64%。本组男23例,女18例。6岁2例,～10岁6例,～14岁33例。轻型13例,中型20例,重型4例,危重型4例(按1981年全     

扩清术后冲洗并负压吸引治疗小儿脓胸21例体会

我科从1984年10月～1987年4月共收治小儿脓胸24例,其中开胸扩清术后胸腔冲洗并持续低负压吸引法治疗21例。疗效满意,现总结如下。一、临床资料1.性别:男12例,女9例,男∶女=4∶3。2.发病年龄:最小2岁,最大10岁。其中2～4岁2例,4～6岁18例,10岁1例。3.发病时间:最短14天,最长44天。因我院早期小儿脓胸均先收入小儿内科,经消炎,胸穿无效转外科手术,所以     

小儿支原体肺炎的肺外病变(附46例分析)

我院 1998年 8月至 2 0 0 0年 6月共收治小儿支原体肺炎 (ＭＰ) 112例 ,其中46例合并有肺外病变 ,现总结报告如下。1　临床资料与方法112例ＭＰ患儿均符合小儿支原体肺炎的临床和实验室诊断标准 ,有肺外病变的 46例患儿中男 2 6例 ,女 2 0例 ,男女比例为 1∶3 ,年龄 6个月至 14岁 ,6个月～ 1岁 2例 ,小于 3岁 8例 ,5～ 12岁 30例 ,有 40例患儿均有不同程度发热 ,多为弛张热和不规则热 ,38例患儿均有咳嗽 ,多为干咳。我们对收治的ＭＰ患儿均做血生化、血、尿、便常规及心肌酶谱检查 ,选做心电图、肝功、脑电图和脑脊液检查。2　结果12 / 46例…     

急性感染性腹泻并发多脏器功能障碍综合征(附42例报告)

我院内科消化病房近十年 (1990年— 2 0 0 0年 )共收治小儿急性感染性腹泻 42 2 4例 ,合并多脏器功能障碍综合征 (ＭＯＤＳ)者 42例 (0 99% ) ,现将临床分析如下。1　临床资料1 1　病例　 42例中男 2 6例 (6 1 9% ) ,女 16例 (38 1% ) ;年龄 3～ 12个月 10例 ,1～ 3岁 16例 ,4～ 7岁 11例 ,8～ 14岁 5例。1 2　诊断标准　全部病例均以发热、腹泻为首发症状。急性感染性腹泻的诊断按文献〔1〕标准 ,ＭＯＤＳ的诊断按文献〔2 ,3〕标准。便常规符合细菌性肠炎35例 ,其中便培养阳性 16例 (福氏痢疾杆菌 12例 ,宋内氏痢疾杆菌 2例 ,沙门氏菌属 2…     

脾切除治疗35例小儿血液病

我院外科自 1980年 1月至 2 0 0 1年 4月收治因血液病药物治疗无效行脾切除病儿 35例 ,占同期小儿脾切除 5 8例的 6 0 .3% ,效果满意 ,现报告如下。1　临床资料1.1　一般资料35例中男 2 4例 ,女 11例 ,男∶女为 2 .2∶1;年龄2～ 14岁 ,其中 2～ 3岁 6例、4～ 9岁 2 0例、10～ 1     

儿童胆汁返流性胃炎20例分析

儿童胆汁返流性胃炎报道较少,我院自1989～1991.5共诊治儿童胆汁返流性胃炎20例,均经内镜检查确诊,现分析如下。临床资料一、临床资料男12例,女8例,男∶女为1.5∶1。年龄7～14岁,其中≤10岁6例,～14岁14例。病史最长1年,最短2周。全部病例均有上腹痛,4例有上腹部轻度压痛,腹痛大多无规律,呈持     

卵巢恶性肿瘤42例

1972～ 1999年我院共收治小儿卵巢恶性肿瘤 4 2例 ,经手术治疗和化疗 ,疗效满意 ,现报告如下。资料与方法一、临床资料　我院 1972～ 1999年共收治卵巢恶性肿瘤患儿 4 2例 ,均经病理证实。本院初治 2 8例 ,外院手术或复发患儿 14例。年龄 6～ 14岁 ,中位年龄 10 .5岁。腹部包块38例 ,腹痛 8例 ,腹胀 17例。肿瘤直径 >30ｃｍ 4例 ,2 0～ 30ｃｍ 2 4例 ,10～ 2 0ｃｍ 12例 ,小于 10ｃｍ 2例 ;ＡＦＰ增高 14例。 4 2例均为生殖细胞恶性肿瘤 ,其中内胚窦瘤 12例 ,无性细胞瘤 17例 ,未成熟畸胎瘤 12例 ,胚胎性癌 1例。按国际妇产科联盟 (ＦＩＧＯ…     

儿童支原体肺炎合并高IgM血症10例

去冬今春,我市支原体肺炎似有小流行趋势,我院共收治10例,现报道分析如下.临床资料一、一般资料:10例中男6例,女4例;男女之比为1.5∶1.发病年龄为3～14岁,其中3～6岁2例,7～9岁6例,10～14岁2例.     

小儿结核性脑膜炎60例临床分析

我院 1995年 1月— 2 0 0 0年 12月收治小儿结核性脑膜炎 (结脑 ) 6 0例 ,现分析报告如下。1　临床资料1 1　一般资料　 6 0例中男 4 4例 ,女 16例 ,男女之比为 2 75∶1。年龄 9个月至14岁 ,其中 >3岁 4 8例 (80 % ) ;农村 5 2例 (86 7% ) ,城市 8例 (13 3% ) ;就诊时病程 6h至 34d ,以 4～ 5d多见 ,共 38例(6 3 3% )。 6 0例均符合 1992年WHO制定的《国际疾病分类》第 10版的诊断标准。1 2　方法　对 6 0例完整的病历进行回顾性分析 ,就其临床特点、实验室及辅助检查结果、发病率及卡介苗接种情况等与有关文献比较。2　结果2 1　发病…     

Comparison of patients with Kawasaki disease with retropharyngeal edema and patients with retropharyngeal abscess

Kawasaki disease with retropharyngeal edema (KD with RPE) is a rare complication, and it is diagnosed by neck CT. Most reported cases had a delayed diagnosis because those patients' conditions were misdiagnosed as retropharyngeal abscess (RPA). The purpose of this study was to differentiate KD with RPE from RPA. We performed a retrospective case–control study comparing children with KD with RPE to those with RPA hospitalized at the tertiary pediatric hospital in Tokyo between 2005 and 2011. The 39 patients revealing RPE on neck CT were divided into two groups: group A was classified as KD (n?=?21) and group B was classified as non-KD (n?=?18). Patients in group B were finally evaluated as having RPA clinically and were treated with antibiotic therapy. A significantly higher proportion of patients in group B complained of dysphagia (11 patients vs. 5 patients; p?=?0.0170) and neck pain (17 patients vs. 12 patients; p?=?0.0106). Neck CT revealed a ring enhancement (16 patients vs. no patients; p?<?0.0001) and mass effect in a greater proportion of patients in group B (11 patients vs. 1 patient; p?<?0.0003). Conclusion: Careful attention to manifestations and close analyses of CT imaging may allow clinicians to differentiate KD with RPE from RPA.     

Patients with moyamoya disease presenting with movement disorder

Moyamoya disease is a rare cerebrovascular disease characterized by idiopathic bilateral stenosis or occlusion of bilateral internal carotid arteries and the development of characteristic leptomeningeal collateral vessels at the base of the brain. Typical presentations include transient ischemic attacks or stroke, and hemorrhage. Presentation with movement disorders is extremely rare, especially in the pediatric population. The authors describe the cases of 4 children with moyamoya disease who presented with movement disorders. Among 446 patients (118 pediatric) with moyamoya disease surgically treated by the senior author, 4 pediatric patients had presented with movement disorders. The clinical records, imaging studies, surgical details, and postoperative clinical and imaging data were retrospectively reviewed. The initial presenting symptom was movement disorder in all 4 patients: chorea in 2, hemiballismus in 1, and involuntary limb shaking in 1. All the patients had watershed infarcts involving the frontal subcortical region on MR imaging. Additionally, 1 patient had a ganglionic infarct. Single-photon emission computed tomography studies showed frontoparietal cortical and subcortical hypoperfusion in all patients. Three patients had bilateral disease, whereas 1 had unilateral disease. All the patients underwent superficial temporal artery-middle cerebral artery bypass. Postoperatively, all 4 patients had complete improvement in their symptoms. The SPECT scans revealed normal perfusion in 3 patients and a small residual perfusion deficit in 1. Movement disorders are a rare presenting feature of moyamoya disease. Hypoperfusion of the frontal cortical and subcortical region was seen in all patients, and the symptomatology was attributed to ischemic dysfunction and imbalance in the cortical-subcortical-ganglionic-thalamic-cortical circuitry. Combined revascularization with superficial temporal artery-middle cerebral artery bypass and encephaloduroarteriosynangiosis leads to excellent results.     

Treatment with probucol of children with familial hypercholesterolaemia

Nine children with familial hypercholesterolaemia, age range 2 to 12 years, were treated with a low cholesterol diet and probucol (10 mg/kg/day). The year before, the children received, as only treatment, a low fat-cholesterol diet. During this period their mean plasma total cholesterol level fell from 8.2 +/- 1.45 mmol/l to 7.17 +/- 0.84 mmol/l (12.6%). This level was further reduced to 5.92 +/- 0.63 mmol/l (17.1%) after the addition of probucol. Plasma high density lipoprotein cholesterol levels were lowered in absolute terms but not in relation to total cholesterol. No apparent side effects were observed. However, the use of probucol should be restricted for the moment to severe cases of hypercholesterolaemia as the long-term excretion of the drug in children is not yet known.