新生儿呼吸道合胞病毒下呼吸道感染30例临床分析

呼吸道合胞病毒(RSV)是婴幼儿下呼吸道感染最重要、最常见的病原体之一[1]。近年来新生儿RSV感染越来越受到关注,由于新生儿免疫功能低下,感染后临床表现较婴幼儿更严重,而且RSV传染性强,易发生新生儿室暴发感染,已成为发达国家     

呼吸道合胞病毒感染的发病机理

自从1956年Chanock从人体分离出呼吸道合胞病毒(Respiratory syncytial Virus下简称RSV)后,对该病毒的致病作用进行了深入的研究。各种研究结果表明RSV感染在世界各地均有发现。它是婴幼儿呼吸道感染最重要的病原之一,尤其是在下呼吸道感染,在对1,000多例呼吸道感染患者进行病毒分离的结果表明,在流行期RSV分离阳性率     

单磷酸阿糖腺苷抑制呼吸道合胞病毒的研究

呼吸道合胞病毒(RSV)是婴幼儿下呼吸道感染的主要病原之一,由它引起的毛细支气管炎和喘息性肺炎是婴幼儿的常见病,对婴幼儿健康危害极大,目前尚无特效抗RSV药。因而,进一步研制新的抗RSV药是十分必要的。本研究显示单磷酸阿糖腺苷(Ara-AMP)具有明显抗RSV作用。 材料和方法 一、材料 病毒培养用液参照文献;Ara-AMP由广     

预防婴儿呼吸道合胞病毒感染的人源化单克隆抗体临床研究最新进展

呼吸道合胞病毒(respiratory syncytial virus,RSV)是导致1岁以下婴儿罹患下呼吸道感染(lower respiratory tract infection,LRTI)的首要病毒病原,严重危害婴儿健康。大部分(约80%)RSV感染的LRTI住院婴儿是足月出生的健康婴儿。目前国内RSV预防和治疗...     

儿童呼吸道合胞病毒感染诊断、治疗和预防专家共识

呼吸道合胞病毒(respiratory syncytial virus,RSV)是世界范围内引起5岁以下儿童急性下呼吸道感染(acute lower respiratory tract infections,ALRTI)最重要的病毒病原[1]。RSV感染是造成婴幼儿病毒性呼吸道感染住院的首要因素,严重危害儿童健康,尤其对早产儿、患有先天性心脏病或原发免疫缺陷的婴幼儿造成的疾病更重。目前,尚无RSV疫苗及有效的抗病毒药物用于RSV的治疗,唯一可用于RSV预防的人源化特异性抗体帕利珠单抗(Palivizumab)尚未引进国内临床应用。临床上在RSV的流行、致病机制、诊断、治疗及预防等方面尚存在一些不足,为进一步规范儿童RSV感染的诊断、治疗及预防,以国内外RSV最新研究进展为参考,特制定此专家共识。     

新生儿呼吸道合胞病毒下呼吸道感染30例临床分析

呼吸道合胞病毒（RSV）是婴幼儿下呼吸道感染最重要、最常见的病原体之一[1]。近年来新生儿RSV感染越来越受到关注,由于新生儿免疫功能低下,感染后临床表现较婴幼儿更严重,而且RSV传染性强,易发生新生儿室暴发感染,     

呼吸道合胞病毒和鼻病毒所致呼吸道感染的临床表现

呼吸道感染在婴纺儿中很普遍,占儿科就诊和住院病例的大多数,其中30～50%是由病毒所引起。呼吸道合胞病毒(RSV),无疑是婴儿及幼儿最主要的病毒病原体,经常引起严重的毛细支气管炎和肺炎。在流行期,首次感染的患病率可高达98%。成人的上呼吸道感染约30%是由鼻病毒(RV)引起。然而,对于RV 在婴幼儿中引起感染的临床情况却知之甚少。在最近的一项调查中,我们证明了RV 是住院婴幼儿下呼吸道感染中仅次于RSV 的最常见原因。资科及方法1984年9月～1986年6月,在519例(男315例,女204例)各种急性呼吸道感染患儿的鼻咽分泌液中筛查呼吸道病毒病原体。患儿年龄10天～3岁(平均6.6月)。471例(91%)为住院患儿,48例,(9%)为门诊患儿。112例(21%)为上呼吸道感染,342例(66%)为下呼吸道感染,65例(13%)呼吸道感染并非就诊原因。所有病例均有急性呼吸道     

呼吸道合胞病毒及其感染的研究近况

呼吸道合胞病毒(RSV)是引起婴幼儿呼吸道感染最主要的病原,由于它在病毒学方面的某些特殊之处,以及其感染的发病机理至今不明,对RSV及其感染性疾病的研究引起国内外的广泛关注。本文主要对七十年代以来国外在这方面的研究情况加以综述。呼吸道合胞病毒的某些特性 RSV为核糖核酸病毒,呈螺旋对称,有外壳。成熟的病毒颗粒在电镜下观察,直径为90～130nm,核壳的直径为11～15nm。经聚丙烯酰胺凝胶电泳测定,RSV由6～8个多肽     

呼吸道合胞病毒感染与儿童哮喘

呼吸道合胞病毒(RSV)是婴幼儿呼吸道感染,尤其是毛细支气管炎(简称毛支)的主要病原体。越来越多的流行病学资料显示,RSV感染的毛支患儿在儿童期易患哮喘。但是,究竟是RSV感染直接诱导或导致哮喘,还是RSV感染的毛支仅仅是哮喘特异性体质的一个早期表现,目前国际上尚无定论。RSV感染后有哪些致病机制与哮喘的发生有关也尚未完全阐明。     

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目的 了解昆明地区呼吸道合胞病毒(RSV)在小儿急性下呼吸道感染中的发生率和临床特征.方法 对昆明市儿童医院2006年4月至2007年4月临床诊断为急性下呼吸道感染的住院患儿1112例行痰间接免役荧光法检测呼吸道合胞病毒抗原.结果 1112例标本中,阳性276例,阳性率24.82%,其中男190例(17.09%),女86例(7.73%),男女发病比例为2.21∶1.全年均可检出RSV,发生率最高的是10～12月份(30.15%),最低的是4～6月份(10.93%).RSV感染多见于3岁以下,尤以6个月以下患儿感染率最高(36.22%).结论 呼吸道合胞病毒是引起昆明地区小儿急性下呼吸道感染的主要病原,特别是婴幼儿感染率最高.     

术中判断肠活力三种方法的比较

术中准确地评价肠活力是外科医师面临的一个普遍问题。应用兔肠缺血模型，比较静脉荧光素、表面血氧测定和激光多普勒三种技术判断肠活力的精确性。结果：诊断效率静脉荧光素法为７８％，表面血氧测定为６８％，激光多普勒为９５％。后者精确度显著优于前二者，且操作简便、迅速，具有临床应用前景。     

早产儿视网膜病的危险因素分析及随访调查

研究早产儿视网膜病(retinopathy of prematurity,ROP)的发生率、高危因素、治疗与随访情况。方法对2005年7月-2007年12月温州医学院附属第一医院NICU收治的符合ROP筛查标准的早产儿,于生后2周开始由资深眼科医师开始行间接眼底镜检查眼底,并进行随访。结果434例早产儿中ROP的发生率为5.5%(24/434例),24例ROP中Ⅰ期19例,Ⅱ期3例,Ⅲ期2例。Ⅲ期阈值病变者行激光光凝治疗,全部患儿均恢复正常。对434例早产儿行单因素分析得出,胎龄、出生体重、住院时间、吸氧、吸氧浓度、吸氧时间、呼吸暂停、新生儿肺透明膜病(RDS)、肺表面活性剂(PS)的应用、机械通气、输血、光疗时间、感染与ROP的发生有相关性(P<0.05)。Logistic回归分析显示胎龄、出生体重、胎数、吸氧时间、光疗时间、代谢性酸中毒、母亲妊高症、颅内出血是影响ROP发生的主要因素。结论早产是ROP的根本原因,防治各种并发症、合理的氧疗是预防ROP的关键。建立完善有效的ROP筛查制度,早期发现、早期治疗ROP,可改善ROP的预后。     

Outcome of the Treatment of Inborn Errors of Metabolism

The use of specific dietary restrictions, cofactor administration, mobilisation of insoluble substances, environmental modifications, product replacement and selective enzyme inhibition are now established for the treatment of some inborn errors of metabolism. There is no generally accepted application for enzyme administration, cytopharmacology (manipulation of the cytoskeleton) or for cell transplantation except for bone marrow transplantation in disorders where the bone marrow is primarily at fault. The other uses of bone marrow transplantation which have been proposed require further evaluation. Results of recent research suggest that the scope of this approach is gradually being widened. There is also scope for development in the field of organ transplantation taking advantage of recent technical¹ and immunological progress. The treatment of inborn errors of metabolism by genetic modification is not yet on a practical clinical level; more laboratory and animal studies are needed before this can be attempted in man. Adenosine deaminase deficiency appears to be the disease in which this will be first attempted using a retroviral vector to insert the gene into the genome of pluripotential bone marrow cells.     

婴幼儿法乐四联症手术治疗近期疗效的影响因素

目的 探讨影响婴幼儿法乐四联症手术治疗近期疗效的各相关因素.方法 将2003年8月至2011年2月经作者一期手术纠治的117例年龄≤3岁的法乐四联症患儿分为疗效良好、疗效较差两组.分析手术时患儿年龄、体重、术前HCT值、McGoon指数、EDVI、主动脉阻断时间、转流时间、室间隔缺损大小、升主动脉与肺动脉干直径比、...     

Spectrum of clinical presentations of vein of Galen aneurysm

Aneurysm of the vein of Galen is a rare intracranial vascular malformation. It is known to have diverse manifestations and varying severity. Four cases with different modes of presentation and outcome are reported. A mortality of 50 per cent was encountered. Among the survivors, one had neurologic sequelae whereas the other had attained age-appropriate developmental milestones. The former was a rare case of spontaneous thrombosis of the aneurysm while the latter was a boy who underwent therapeutic embolization.     

主动脉缩窄的治疗研究进展

主动脉缩窄(coarctation of aorta,CoA)是主动脉的局限性狭窄,狭窄最常见于峡部,是一种常见的先天性心血管畸形,占所有先天性心脏病的5％ ～8％.缩窄导致上肢血压升高,下肢血压降低,并可引起心功能下降,未经治疗的CoA预后不佳.治疗方式包括外科治疗及经皮介入治疗,不同治疗方式的并发症发生率不同,术后长期监测其并发症、心功能是评估预后的重要指标.该文对主动脉缩窄的治疗方式及术后并发症、心功能情况的研究进展作一综述.     

小儿法洛四联症根治术106例临床分析

目的探讨小儿法洛四联症根治术的特点,以提高手术疗效。方法对1998-02—2005-07在河南省郑州市第七人民医院接受法洛四联症根治术的106例患儿的临床资料进行回顾性分析。结果治愈103例,死亡3例,病死率为2.9%。术后随访率100%,随访3～93个月,无晚期死亡。全部病例心功能皆恢复至Ⅰ或Ⅱ级(NYHA)。结论绝大部分法洛四联症患儿可施行一期根治术,提高手术成功率的关键在于合理的体外循环灌注、严密修补室间隔缺损和恰当疏通右室流出道。     

Treatment of retinopathy of prematurity

Retinopathy of prematurity is a potentially blinding disorder of premature infants. Retinal ablation of the avascular retina originally described using cryotherapy but now most commonly undertaken with laser photocoagulation, reduces the unfavourable structural outcomes and improves the functional visual acuity outcome. The CRYO-ROP study showed the long-term benefit of treatment of threshold disease compared with no treatment, however even with cryoablation 44.4% of treated eyes had a visual acuity of 6/60 or worse at 10 year follow-up. The ETROP study of earlier treatment for high-risk pre-threshold disease, rather than treatment at threshold, has shown that pre-threshold treatment of type 1 disease produces a significantly improved outcome. Despite treatment some infants develop retinal detachment for which various surgical treatments have been described, although not always with a good functional outcome. Future treatment modalities may include the use of anti-VEGF therapies.     

Reliability of subjective estimates of exercise capacity after total repair of tetralogy of Fallot

Sixty-nine patients (age 10 × 3.5 years, median 9.7 years) operated on for tetralogy of Fallot, underwent excercise testing 5.1 × 2.5 years after total correction. Aerobic capacity was assessed by the ventilatory threshold method. After the exercise test, parents completed a validated standardized questionnaire to evaluate the habitual level of physical activity of their child. They were then asked to place their child into one of three groups, describing their child's activity level, compared to normals (below average, average and above average). In the average and above-average groups, 73% and 65% of the patients were misclassified when compared to objective exercise testing. However, in the below-average group, no misclassifications were found. Subjective estimates of activity level, and consequently exercise tolerance, were poorly associated with objective measurements of exercise performance in these patient groups. Our results question the reliability of self-reported estimates of physical activity level and consequently exercise capacity in children after surgical correction of tetralogy of Fallot.