小儿会厌囊肿合并呼吸困难的麻醉管理

会厌囊肿好发于会厌舌面，属良性肿瘤，如肿瘤较小，常无明显临床症状，当肿瘤较大或合并呼吸道感染时常出现上呼吸道梗阻现象。如麻醉方法不当可引起呼吸道梗阻、窒息，严重者可危及生命。     

对3370例上呼吸道感染小儿并发急性中耳炎情况的调查

在美国等西方国家,20世纪90年代的统计数字表明,近2／3的婴幼儿至少患过1次急性中耳炎,50％的儿童患过两次或更多。为了了解我院儿科上呼吸道感染并发急性中耳炎的情况,于2002年1～12月对来我院门诊就诊时登记在册的上呼吸道感染的患儿3370例,均行耳窥镜检查,发现疑似急性中耳炎,再由耳鼻喉科会诊,现将结果报告如下。     

小儿上呼吸道感染的病毒检测与分析

急性呼吸道感染是儿科最常见疾病,严重威胁着小儿的健康。明确病原体是治疗的关键。为此,我们于1997年11月至1998年6月对济南地区诊断为上呼吸道感染的患儿,采用桥联酶标法进行病毒原快速诊断。现报告分析如下。     

大剂量地塞米松＋雾化吸入治疗小儿急性喉炎Ⅲ度喉梗阻体会（附46例报告）

急性喉炎喉梗阻是小儿常见的危重急症之一。我科自1996年2月起对小儿急性喉炎伴Ⅲ度喉梗阻采用大剂量地塞米松静注＋超声雾化吸入治疗，取得满意疗效。现总结报告如下。     

小儿上呼吸道感染并高热惊厥的院前防范教育和院内急救

目的 探讨上感并高热惊厥院前防范和院内急救的临床意义。方法 对102例患儿进行院前防范指导和院内急救处理。结果 通过院前防范指导，再发明显减少；院内正确急救，无脑损伤出现。结论 院前防范是减少再次发作的关键，院内正确的急救可缩短惊厥时间、避免脑损伤。     

氧雾吸入配合治疗小儿喉炎的护理

急性感染性喉炎又称“急性声门下喉炎”，好发春、冬二季，常见于1～3岁幼儿。小儿急性喉炎病情发展快，易并发喉梗阻，治疗应及时。以往以抗病毒及激素静脉用药治疗为主，但全身副作用较大。我科用氧雾吸入配合治疗小儿喉炎，疗效迅速良好，现报告如下。     

A double-blind pediatric evaluation of levamisole in the prevention of recurrent upper respiratory tract infections

Levamisole was tested double-blind in 106 children with recurrent upper respiratory tract infections. They received either levamisole (n=53) or placebo (n=53) 0.5 ml/kg bodyweight b.i.d. for two consecutive days each week for six months. A control examination was performed every two months. Both groups were compared by means of the Fisher-test and the Mann-Whitney U-test (two-tailed probability each). Improvement was observed more frequently in the levamisole group with regard to the number of episodes of infection, and the total duration and severity of the infections. No side-effects, except for some stomach complaints in one levamisole patient, were reported.     

Suppurative intracranial complications of upper respiratory tract infections

Suppurative intracranial complications of respiratory infections are relatively rare in children. These complications occur more often in association with chronic sinusitis and chronic otitis media. Because symptoms and signs of the intracranial complications can be nonspecific, a high index of suspicion by the physician is important for early diagnosis. The routine cerebrospinal fluid examination often does not distinguish between the various complications, and radiologic procedures such as radionuclide brain scan, arteriography and computer-assisted tomographic scan should be used. Computer-assisted tomographic scan is very useful in detecting early complications allowing trial with medical treatment alone. Appropriate selection of antibiotics must be made on the basis of the likely pathogens in the particular setting and the ability of the antibiotic to penetrate the affected area. Appropriate early management of suppurative intracranial complications should result in a favorable outcome.     

Role of anaerobic beta-lactamase-producing bacteria in upper respiratory tract infections

Bacteroides sp. (Bacteroides melaninogenicus, Bacteroides oralis and Bacteroides fragilis), peptostreptococci and Fusobacterium sp. are important pathogens in upper respiratory tract infections. A recent increase in numbers of beta-lactamase-producing strains of anaerobic Gram-negative bacteria in upper respiratory tract infections has been associated with increased failure rates of penicillins in eradication of these infections. These infections include chronic otitis media, chronic sinusitis and mastoiditis, chronic recurrent tonsillitis and lung abscesses. The indirect pathogenicity of these organisms is apparent through their ability not only to survive penicillin therapy but also to protect penicillin-susceptible pathogens from the drug. These direct and indirect virulence characteristics of anaerobic bacteria require the administration of appropriate antimicrobial therapy directed against all pathogens in mixed infections.     

Roentgenographic features of common pediatric viral respiratory tract infections

Viral infections of the respiratory tract in infants and children are common. Little has been reported on roentgenographic findings associated with infection caused by common viruses other than with respiratory syncytial virus. We studied chest roentgenograms from 128 previously healthy infants and children who were infected with respiratory syncytial virus, parainfluenza virus, influenza virus, or adenovirus. Four common roentgenographic findings were detected: parahilar peribronchial infiltrates, hyperexpansion, segmental or lobar atelectasis, and hilar adenopathy. Diffuse interstitial infiltrates and significant pleural fluid accumulations rarely occurred in our series. We confirmed the popular but not well-documented belief that other common respiratory viruses can be associated with roentgenographic findings similar to those caused by respiratory syncytial virus. However, respiratory syncytial virus infection is associated with more abnormal chest roentgenograms than any of the other viruses regardless of the clinical syndrome. Hilar adenopathy was more common in adenovirus infection. Young infants had significantly more abnormal chest roentgenograms, with more hyperexpansion and parahilar peribronchial infiltration than older children. We also found a significant correlation between lobar atelectasis and severity of the illness. In infants and children with viral infection of the lower respiratory tract, roentgenographic information can be a useful adjunct to clinical viral diagnosis.