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1.
《临床儿科杂志》2023,(4):300-310
<正>新型冠状病毒(严重急性呼吸综合征冠状病毒2,SARS-CoV-2,简称新冠病毒),大流行初期,儿童传播率远低于成人,但在最近一波奥密克戎(Omicron)变异株大流行中传播率急剧上升。与新冠病毒原始株、阿尔法、贝塔和德尔塔变异株相比,新的Omicron变异株主要表现为上呼吸道疾病,但严重的非肺部疾病,  相似文献   

2.
目的分析儿童感染Omicron变异株后发生热性惊厥的临床特征。方法回顾性收集2022年12月1—31日(Omicron变异株流行期间,设为Omicron组)和2021年同期(非Omicron组)就诊于首都儿科研究所附属儿童医院神经内科热性惊厥患儿的临床资料,分析比较两组患儿的临床特征。结果Omicron组381例,男性250例,女性131例,平均年龄(3.2±2.4)岁。非Omicron组112例,男性72例,女性40例,平均年龄(3.5±1.8)岁。Omicron组人数明显增多,是非Omicron组的3.4倍。Omicron组1岁~和6~10.83岁两个年龄段患儿占比高于非Omicron组,4岁~和5岁~两个年龄段患儿占比低于非Omicron组(P<0.05)。Omicron组丛集性发作和惊厥持续状态比例高于非Omicron组(P<0.05)。热性惊厥复发患儿中,Omicron组6~10.83岁占比高于非Omicron组,3岁~、4岁~、5岁~占比低于非Omicron组(P<0.05)。结论儿童感染Omicron变异株后热性惊厥的特征是年龄范围更广,在一次发热病程中丛集性发作和惊厥持续状态的比例增加。  相似文献   

3.
目的 探讨新型冠状病毒Omicron变异株感染患儿的临床特征。 方法 回顾性收集2022年3月14日—4月7日泉州市第一医院201例确诊为新型冠状病毒Omicron变异株感染的住院患儿的临床资料。其中无症状感染34例,有症状感染167例。比较两组患儿临床特征、辅助检查结果及转归。 结果 201例患儿中,161例(80.1%)有新型冠状病毒感染患者接触史,132例(65.7%)有新型冠状病毒感染疫苗接种史。167例有症状感染患儿中,轻型151例,普通型16例,无重症感染及死亡病例。101例进行胸部CT检查的患儿中,16例有磨玻璃样改变,20例有结节状或条索影改变。201例患儿新型冠状病毒核酸转阴时间为(14±4)d,其中有症状感染组核酸转阴时间长于无症状感染组[(15±4)d vs(11±4)d,P<0.05]。接种1剂或2剂新型冠状病毒感染疫苗组IgG检出阳性率高于未接种疫苗组(P<0.05)。有症状感染组血淋巴细胞计数增高比例低于无症状感染组(P<0.05);有症状感染组白细胞介素-6水平增高、血纤维蛋白原增高及D-二聚体增高患儿比例均高于无症状感染组(均P<0.05)。 结论 感染Omicron变异株的患儿多有临床症状,但临床症状一般较轻。有症状感染患儿多伴有血淋巴细胞计数降低或正常,以及白细胞介素-6、纤维蛋白原、D-二聚体升高表现,且核酸转阴时间较长,部分患儿胸部CT呈磨玻璃样改变。  相似文献   

4.
背景:新型冠状病毒疫苗(简称新冠疫苗)接种对于控制疫情大流行并减少新冠肺炎重症发生率具有重要作用,有过敏性疾病史儿童人群接种新冠疫苗中的安全性是现实问题。 目的:为有过敏性疾病史的儿童接种新冠疫苗提供建议。 设计:病例系列报告。 方法:纳入2021年8月12日至2021年12月3日至复旦大学附属儿科医院疫苗咨询门诊咨询新冠疫苗接种的3~17岁儿童和青少年。根据儿童的既往史、目前健康状态以及家长的问题进行个体化评估,给予暂缓接种或推荐接种建议,电话随访接种后72 h内、28 d内和3个月时有无征集的疫苗接种后不良事件(AEFI)以及家长主动报告的任何非征集的不良事件;行AEFI与疫苗的因果关联评估。 主要结局指标:新冠疫苗AEFI。 结果:接受新冠疫苗接种咨询的儿童116例,男67例(57.8%),女49例,年龄(10.1±3.1)岁,经疫苗咨询门诊个体化评估后推荐接种(组)77例(66.4%),暂缓接种(组)39例。有过敏性疾病史70例(60.3%),其中 25例因处于过敏性疾病急性期建议暂缓接种,既往其他疫苗或药物过敏史11例(9.5%)中5例因严重过敏反应期建议暂缓接种,非药物过敏史13例(11.2%)中5例因处于疾病急性期、特应性体质21例(18.1%)中3例因患急性疾病(呼吸道感染),1例(0.9%因既往接种新冠疫苗1剂过敏)建议暂缓接种。暂缓接种组儿童于疫苗咨询门诊咨询后后3个月行电话随访均未接种新冠疫苗。推荐接种组77例儿童均完成了3次随访,实际接种亚组54例(47例接种了2剂次疫苗,7例接种了1剂次疫苗);实际未接种亚组23例,两亚组性别、过敏性疾病史、其他疫苗或药物过敏史、非药物过敏史和特应性体质差异均无统计学意义, 年龄差异有统计学意义[(10.4±3.0)岁vs(9.0±3.1)岁,P=0.04]。接种后4 d和28 d的电话随访未报告征集的严重过敏反应。接种后72 h内18例(17.8%)报告征集的不良反应事件,其中皮疹和咳嗽各5例(5.0%),流涕4例(4.0%),纳差和发热各3例(3.0%),咽痛2例 (2.0%),乏力、肌痛、恶心、呕吐各1例(1.0%),经判断与新冠疫苗接种有因果关联。接种后28 d和3个月电话随访未再报告征集的不良反应。接种后28 d内家长主动报告5例非征集不良事件,其中特发性皮炎或湿疹发作3例(3.0%)、 过敏性鼻炎发作2例(2.0%),初步判断与新冠疫苗接种无因果关联。接种后28 d内新冠疫苗AEFI发生率 33.3% (18/54)。 结论:过敏性疾病缓解期、有其他疫苗或药物非严重过敏史、非药物过敏史、特应性体质儿童接种新冠病毒灭活疫苗是安全的,新冠疫苗AEFI均发生在接种后72 h内,与新冠疫苗接种有因果关联。  相似文献   

5.
背景:目前国内外对高剂量甲氨蝶呤(MTX)排泄延迟是否应该使用血液透析解救还存在争议。 目的:研究高通量血液透析(HF-HD)对肿瘤患儿MTX清除的有效性。 设计:病例系列报告。 方法:纳入2016年1月至2021年6月在上海交通大学医学院附属上海儿童医学中心血液肿瘤科行MTX化疗后44 h血药浓度>10 μmol·L-1的连续病例,其中仅使用亚叶酸钙(CF)解救的患儿为非HF-HD组,使用HF-HD+CF解救的患儿为HF-HD组。比较2组患儿的胃肠道、肝功能、肾功能和血液系统毒性等指标。 主要结局指标:肝、肾功能不良反应发生率。 结果:20例发生20例次MTX延迟排泄,非HF-HD组9例,HF-HD组11例,两组患儿美国卫生及公共服务部常见不良事件评价标准v 4.0项目比较,CF组和HF-HD组肌酐、尿酸、ALT、AST、黏膜炎、24 h MTX浓度、MTX浓度恢复正常所需的时间差异均无统计学意义,两组患儿血液系统不良反应发生率差异无统计学意义(P>0.05);AST、ALT、发热、黏膜炎、WBC、NE、Hb、PLT异常发生率两组差异无统计学意义。 结论:肾功能正常的肿瘤患儿通过CF解救可有效安全清除MTX,非必要不选择透析。  相似文献   

6.
目的评估伴免疫抑制相关基础疾病的儿童重症监护室脓毒症患儿入PICU 28 d内死亡及其危险因素。方法病例对照研究。回顾性收集复旦大学附属儿科医院(我院)因脓毒症/脓毒性休克收入PICU的患儿临床资料,分为免疫抑制组和免疫健全组,考察免疫抑制患儿入PICU 28 d内死亡的危险因素。结果2015年12月1日至2018年12月31日我院PICU出院诊断脓毒症连续病例385例,排除入科后24 h内死亡和PICU获得性脓毒症病例,251例PICU脓毒症/脓毒性休克患儿进入本文分析,免疫抑制组110例 (43.8%),免疫健全组141例。与免疫健全组比较,免疫抑制组以住院转入患儿(70%)为主,PICU维持治疗需求(血管活性药物、有创/无创机械通气)高、24 h PRISM评分高,不明确感染部位比例高,免疫抑制组接受ECMO治疗者全部死亡,持续肾脏代替治疗(CRRT)存活率为17.4%,入PICU第28 d病死率69.1%。免疫健全组和免疫抑制组28 d内存活和死亡患儿比较,除脓毒性休克、有创机械通气、CRRT、PRISM Ⅲ评分、乳酸>2 mmol·L-1比例、PICU住院时间、总住院时间、脱离PICU时间、24 h内放弃治疗、总放弃治疗差异有统计学意义外,应用血管活性药物在免疫抑制组入PICU 28 d内存活和死亡因素比较中差异有统计学意义。多因素COX比例风险模型分析显示,PRISM Ⅲ评分、有创机械通气、乳酸>2 mmol·L-1是免疫抑制组和免疫健全组入PICU 28 d内病死率的共同危险因素,休克是免疫抑制组入PICU 28 d内病死率的危险因素。结论重症监护室脓毒症患儿病死率较高;伴免疫抑制相关基础疾病的脓毒症患儿病死率更高;PRISMⅢ评分、48 h内有创机械通气和入院乳酸值(>2 mmol·L-1)是其预后的重要危险因素。应建立早期预警指标,对免疫抑制患儿进行早期识别,早期干预,可能改善预后。  相似文献   

7.
目的 通过比较接种/未接种新型冠状病毒灭活疫苗(简称新冠疫苗)后感染新型冠状病毒Delta变异株的新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)患儿的临床特征,为儿童COVID-19的临床诊疗提供参考。 方法 将2021年11月3日至12月17日河南省定点救治医院收治的接种新冠疫苗后感染新型冠状病毒Delta变异株的COVID-19患儿11例纳入接种疫苗组,同期住院的未接种新冠疫苗感染新型冠状病毒Delta变异株的COVID-19患儿31例纳入未接种疫苗组,回顾性收集两组患儿的流行病学、临床特征及实验室检查资料进行比较。 结果 两组患儿性别构成和疾病分型比较差异均无统计学意义(P>0.05)。咳嗽、咳痰、发热等临床症状发生率在两组间比较差异均无统计学意义(P>0.05)。白细胞计数、淋巴细胞百分比、丙氨酸氨基转移酶水平、血肌酐水平升高发生率在两组间比较差异均无统计学意义(P>0.05)。接种疫苗组患儿天冬氨酸氨基转移酶、乳酸脱氢酶、肌酸激酶同工酶水平明显低于未接种疫苗组(P<0.05)。两组患儿C反应蛋白、降钙素原水平增高发生率及外周血细胞因子水平比较差异均无统计学意义(P>0.05)。接种疫苗组患儿B淋巴细胞和总T淋巴细胞(CD3+)计数低于未接种疫苗组(P<0.05)。接种疫苗组患儿在入院时、病程第2周的IgG阳性率均高于未接种疫苗组(P<0.05)。在病程第1周、第2周接种疫苗组患儿新型冠状病毒核酸Ct值较未接种疫苗组增高(P<0.05)。 结论 接种新冠疫苗可能会减少新型冠状病毒Delta变异株对患儿心肌的损害,接种新冠疫苗后再感染新型冠状病毒Delta变异株的患儿,更需警惕其免疫功能受损。  相似文献   

8.
目的 了解呼吸道病毒混合感染所致急性下呼吸道感染(ALRTI)患儿的临床特征。方法 2007年10月至2011年9月,在首都医科大学附属北京儿童医院住院治疗的临床诊断为ALRTI的患儿1722例,在就诊当日或次日采集鼻咽吸取物1份,采用逆转录(RT)-PCR方法进行常见呼吸道病毒核酸检测,包括呼吸道合胞病毒(RSV)、鼻病毒(RV)、副流感病毒(PIV)1~4型、甲型及乙型流感病毒、腺病毒、肠道病毒、冠状病毒、偏肺病毒及博卡病毒。将单一RSV感染与RSV混合多种病毒感染患儿临床资料进行比较。结果 1722例患儿标本中,370例检出RSV病毒,总检出率21.5%。单一RSV感染206例,RSV与一种病毒混合感染124例,RSV与2种以上病毒混合感染40例。RSV与一种病毒混合感染的124例标本中,RSV/RV感染68例(54.8%),其次为RSV/PIV感染24例(19.3%)。双重病毒混合感染组与RSV单一病毒感染组比较,双重病毒混合感染组患儿住院时间更长(P<0.001)。多重病毒感染组与RSV单一病毒感染组相比,患儿发热比例更高(P=0.017)、发热持续时间更长(P=0.015)、住院天数延长(P<0.001)、并且在住院期间接受了更多的静脉激素治疗(P=0.005)。而在喘息症状、出现合并症(心力衰竭、呼吸衰竭、肝功损害、心肌损害、腹泻)方面差异无统计学意义。在氧疗、呼吸支持治疗及使用支气管扩张剂方面差异亦无统计学意义。结论 与单一RSV感染组相比,RSV合并多重病毒感染患儿发热比例更高、发热持续时间及住院天数更长,且住院期间接受了更多的静脉激素治疗。提示多病毒混合感染可能影响患儿临床进程, RSV感染时应重视混合感染。  相似文献   

9.
背景:新型冠状(新冠)病毒奥密克戎变异株传染力极强,使得上海市2022年3至5月新冠病毒奥密克戎疫情(简称:本次疫情)防控之初就兼具复杂性、动态性和不确定性多重特质,使得医院的防控更具挑战。 目的:探讨实施气泡式管理策略对防控新冠病毒医院感染和职业暴露的效果。设计:观察性研究。 方法:将本次疫情复旦大学附属儿科医院(我院)院内接诊 门诊 急诊 住院 出院设计为一个大气泡,大气泡中6个疫情防控医疗关键部门设计为中气泡,中气泡的9个要隘部门设计为小气泡。①新冠门急诊中气泡接诊健康码红码患儿,五级分诊Ⅰ和Ⅱ级导入抢救室小气泡, Ⅲ~Ⅴ级导入阳性小气泡、既往感染小气泡、密切接触者(密接)小气泡,放射检查室小气泡内接诊新冠门急诊和新冠病房需进行X线/CT检查的患儿;②发热门急诊中气泡接诊绿码/黄码伴发热的患儿;③急诊中气泡接诊绿码/黄码不伴发热的患儿,根据患儿有无48 h内核酸检测阴性报告分流至缓冲区和急诊区,配备第二急诊室备用;④新冠病房中气泡接收新冠门急诊需要收治住院的患儿,重型/危重型收入新冠ICU小气泡,轻型/普通型收入新冠普通病房小气泡;⑤过渡病房中气泡接收除危重症和新生儿外的新入院患儿;⑥新生儿隔离病房中气泡接收医疗机构通过120救护车转运到我院院区的新生儿,收入新生儿隔离病房负压病室小气泡,连续3 d核酸检测,阳性即转入新冠病房,均阴性则转至非负压病室小气泡。不同风险等级的气泡间人员、物品不流动,工作人员从低一级风险进入高一级风险需上报医务科。设立气泡破泡预案。根据工作人员不同岗位制定规范的培训内容及考核要求,通过语音视频监控系统和现场督查进行检查。 主要结局指标:职业暴露和新冠病毒医院感染。 结果:我院累计收治新冠阳性患儿432例,其中轻型341例(78.9%),普通型88例(20.4%),危重型3例。3例危重型患儿均行有创机械通气,1例行连续肾脏替代治疗和体外膜肺氧合。无死亡病例。伴基础疾病29例。陆续有109名医务人员进入新冠门急诊和新冠病房工作,其中医生46人、护士49人、医技人员9人、医辅人员5人。未发生职业暴露,未发生新冠病毒医院感染。门急诊接诊253 571人次,在医院入口筛查,拦截红码189人次,红码患儿均顺利导入新冠门急诊,未进入普通门急诊区域。急诊接诊12 114人次,经核酸检测筛查出6例新冠阳性患儿,其中3例进入急诊区小气泡,引起急诊中气泡3次封闭消杀,启用第二急诊。发热门急诊接诊8 328人次,核酸检测阳性50例,转入新冠门急诊;新冠门急诊接诊763人次,五级分诊Ⅰ级和Ⅱ级共4例,3例为新冠肺炎危重型;收治新生儿690例,其中低危流行病史516例,高危流行病史174例;过渡病房收治693例,其中急诊入院223例,择期入院470例。所有进入隔离病区工作的医务人员均参加基础理论培训,高风险气泡专项培训29次,培训291人次,理论培训和操作培训均考核合格,视频监控和现场督查304人次。 结论:本次疫情期间在我院实施气泡式管理取得了新冠病毒医院感染和职业暴露双零效果。  相似文献   

10.
目的 探讨免疫性血小板减少性紫癜(ITP)与病毒感染的关系.方法 回顾性分析60例儿童ITP的临床资料,采用ELISA法检测60例ITP患儿血清病毒抗体,包括EB病毒(EBV)及巨细胞病毒(CMV)等,比较病毒抗体检测在病毒感染组及非病毒感染组ITP患儿中的临床特点及治疗效果.结果 病毒血清学检测:病毒感染36例,非病毒感染24例.病毒感染组与非病毒感染组比较:(1)皮肤黏膜出血点及瘀斑例数、鼻出血例数及消化道出血例数比较差异均无统计学意义(Pa>0.05).(2)2组Hb及血小板计数比较差别均无统计学意义(Pa>0.05).(3)治疗2个月效果比较差异有统计学意义(P<0.05),病毒感染组初始疗效较非病毒感染组治疗有效率低.(4)治疗6个月2组疗效比较差异有统计学意义(P<0.05),治疗6个月病毒感染组无效13例,39.4%呈慢性倾向,明显高于非病毒感染组(10.0%).结论 多数ITP患儿伴有病毒感染;病毒感染相关的ITP疗效较非病毒感染的ITP疗效差,导致病程迁延.对并病毒感染的TTP患儿应进行抗病毒治疗.  相似文献   

11.
目的 分析甲型流感(甲流)患儿病毒核酸持续时间的规律和影响因素。方法 收集90例鼻咽拭子甲流病毒核酸PCR检测阳性的甲流患儿临床资料,并将其分为单纯甲流组(10例)、甲流并发肺炎组(61例)、甲流并发神经系统损害组(10例)、基础疾病合并甲流组(9例),对其临床特点、治疗经过、病毒核酸持续时间和转归进行回顾性分析。结果 90例甲流患儿的前5位临床症状主要为发热(89/90,99%)、咳嗽(89/90,99%)、流涕(69/90,77%)、气促(26/90,29%)、肌痛(23/90,26%)。病毒核酸持续时间平均9.4±2.9 d。单纯甲流组病毒核酸持续时间短于甲流并发肺炎组、甲流并发神经系统损害组及基础疾病合并甲流组,差异均有统计学意义(P < 0.05);甲流并发肺炎组、甲流并发神经系统损害组及基础疾病合并甲流组之间的病毒核酸持续时间的差异均无统计学意义(P > 0.05)。起病48 h内抗病毒治疗组的病毒核酸持续时间和体温恢复正常所需时间均短于48 h以后用药的患儿,差异有统计学意义(P < 0.05)。83%的体温恢复正常的甲流患儿病毒核酸仍呈阳性。结论 并发症、基础性疾病和抗病毒治疗时机是影响甲流病毒核酸持续的主要因素,体温是否恢复正常不宜作为甲流患儿是否继续抗病毒治疗的参考。  相似文献   

12.
The novel coronavirus SARS‐CoV‐2 has emerged as one of the most compelling and concerning public health challenges of our time. To address the myriad issues generated by this pandemic, an interdisciplinary breadth of research, clinical and public health communities has rapidly engaged to collectively find answers and solutions. One area of active inquiry is understanding the mode(s) of SARS‐CoV‐2 transmission. Although respiratory droplets are a known mechanism of transmission, other mechanisms are likely. Of particular importance to global health is the possibility of vertical transmission from infected mothers to infants through breastfeeding or consumption of human milk. However, there is limited published literature related to vertical transmission of any human coronaviruses (including SARS‐CoV‐2) via human milk and/or breastfeeding. Results of the literature search reported here (finalized on 17 April 2020) revealed a single study providing some evidence of vertical transmission of human coronavirus 229E; a single study evaluating presence of SARS‐CoV in human milk (it was negative); and no published data on MERS‐CoV and human milk. We identified 13 studies reporting human milk tested for SARS‐CoV‐2; one study (a non‐peer‐reviewed preprint) detected the virus in one milk sample, and another study detected SARS‐CoV‐2 specific IgG in milk. Importantly, none of the studies on coronaviruses and human milk report validation of their collection and analytical methods for use in human milk. These reports are evaluated here, and their implications related to the possibility of vertical transmission of coronaviruses (in particular, SARS‐CoV‐2) during breastfeeding are discussed.  相似文献   

13.
A prospective randomised, double blind, controlled trial was conducted in 52 infants to determine whether recombinant interferon alfa-2a (INF-alpha-2a) would reduce the morbidity of acute bronchiolitis and the respiratory syncytial virus shedding time. All infants had a positive direct antigen immunofluorescence test for respiratory syncytial virus. INF-alpha-2a (50,000 IU/kg/day) or placebo was administered by daily intramuscular injection for three consecutive days. Sixteen infants received INF-alpha-2a and 36 received placebo treatment. The two groups were similar in demographic characteristics and initial oxygenation. The treatment group, however, had a significantly higher overall score for severity of illness at the start of treatment. More rapid drop of the clinical score was observed in the INF-alpha-2a group after treatment in the first three days and the two groups had similar clinical severity by day 3. There was no significant difference of the duration of viral shedding in the two groups. In conclusion, the overall clinical improvement was greater in the treatment group over the first three days, but the duration of viral shedding was not altered.  相似文献   

14.
A prospective randomised, double blind, controlled trial was conducted in 52 infants to determine whether recombinant interferon alfa-2a (INF-alpha-2a) would reduce the morbidity of acute bronchiolitis and the respiratory syncytial virus shedding time. All infants had a positive direct antigen immunofluorescence test for respiratory syncytial virus. INF-alpha-2a (50,000 IU/kg/day) or placebo was administered by daily intramuscular injection for three consecutive days. Sixteen infants received INF-alpha-2a and 36 received placebo treatment. The two groups were similar in demographic characteristics and initial oxygenation. The treatment group, however, had a significantly higher overall score for severity of illness at the start of treatment. More rapid drop of the clinical score was observed in the INF-alpha-2a group after treatment in the first three days and the two groups had similar clinical severity by day 3. There was no significant difference of the duration of viral shedding in the two groups. In conclusion, the overall clinical improvement was greater in the treatment group over the first three days, but the duration of viral shedding was not altered.  相似文献   

15.
Herpes simplex virus type 1 and type 2 cause a wide range of illnesses ranging from minor cold sores to severe necrotising encephalitis or disseminated systemic infections seen in immunocompromised patients including neonates. Following primary infection, the virus is not eradicated from the body but is latent in sensory nerve ganglia where it can reactivate and cause recurrent disease. Aciclovir is the most studied and used antiviral agent with activity against herpes simplex virus infections. In most situations the use of aciclovir shortens the duration of clinical illness and viral shedding and reduces morbidity and mortality. All life- or sight-threatening infections should be managed in an inpatient hospital setting with intravenous therapy. The use of oral aciclovir is recommended in patients with non-life-threatening illness who may still have significant symptoms.  相似文献   

16.
In immunocompromised patients, the NoV infection is prolonged and severe. We retrospectively studied the severity of the NoV infection in children after an ITx, the treatment, and the long‐term evolution. Norovirus PCR in stools was positive for 19 children in 21 separate episodes. The infection was symptomatic in 18 cases. At diagnosis, the median weight loss was 5% (0‐11) and the creatinine clearance was 75 mL/min/1.73 m2 (19‐142). On 14 digestive biopsies, the pathological findings were non‐specific with a constant mononuclear infiltration, showing signs of rejection in one case. Fifteen children in 17 cases were hospitalized for a median duration of 41 days (0‐119) with IV infusions for 33 days (0‐120). The viral shedding lasted 78 days (20‐360). Nine children with severe or prolonged diarrhea received intravenous IGs and four of them additional NTZ. On follow‐up, five other children developed a rejection 12 months (1‐33) after NoV infection. Four uncontrolled rejections led to graft removal. Children mostly needed hospital admission and IV rehydration, but the symptoms upon presentation were moderate. Symptoms and shedding durations are prolonged as expected. The treatment efficacy cannot be assessed. The rejection induction by the NoV cannot be excluded.  相似文献   

17.
目的 分析亲子病房收治模式下,家庭聚集性感染Omicron变异株的儿童及其家属的临床特点及转归。 方法 回顾性收集上海市第六人民医院新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)定点医院于2022年4月8日至5月10日收治确诊的感染Omicron变异株患儿190例及其家属190例的临床资料,进行分析总结。 结果 儿童组和成人组均以轻型为主,儿童组轻型比例高于成人组(P<0.05);2组临床表现均以上呼吸道症状为主,儿童组发热、腹痛腹泻、喘息发生率高于成人组(P<0.05),鼻塞流涕咳嗽、咽干咽痒咽痛发生率低于成人组(P<0.05);成人组治疗连花清瘟颗粒/小儿豉翘清热颗粒、中药汤剂、重组人干扰素α2b喷雾剂、止咳化痰药、奈玛特韦/利托那韦片使用率均高于儿童组(P<0.05);儿童组疫苗接种率(30.5%)较成人组(71.1%)低(P<0.001),而儿童组严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)核酸阳性持续时间短于成人组(P<0.05)。2组临床轻型者SARS-CoV-2核酸阳性持续时间短于普通型者(P<0.05)。2组有基础疾病者SARS-CoV-2核酸阳性持续时间长于无基础疾病者(P<0.05)。 结论 家庭聚集性Omicron变异株感染儿童和成人的临床分型均以轻型为主。尽管儿童疫苗接种率较低,但在亲子病房收治模式中,疾病恢复较快,SARS-CoV-2核酸阳性持续时间短于成人。  相似文献   

18.
SARS: future research and vaccine   总被引:2,自引:0,他引:2  
Severe acute respiratory syndrome (SARS) is a new infectious disease of the 21st century that has pandemic potential. A novel coronavirus (CoV) was identified as its aetiological agent and its genome was sequenced within months of the World Health Organisation issuing a global threat on SARS. The high morbidity and mortality of this potentially pandemic infection demands a rapid research response to develop effective antiviral treatment and vaccine. This will depend on understanding the pathogenesis and immune response to SARS CoV. Further understanding of the ecology of SARS CoV in human and animals will help prevent future cross species transmission. Likewise for the super-spreading events, clarification of the underlying reasons will be important to prevent a large scale outbreak of SARS. Lastly it is of utmost importance that international research collaboration should be strengthened to deal with SARS and any other emerging infectious disease that can seriously threaten our future.  相似文献   

19.
Li ZH  Dong M  Sun XJ  Shen J  Wan WL  Qi JM  Wang C  Ding GF  Wang DH 《中华儿科杂志》2011,49(3):222-225
目的 回顾超低出生体重儿(ELBWI)胃肠道内喂养的临床资料,分析影响ELBWI胃肠道内喂养的各种因素.方法 对2000年1月至2010年1月间的24例ELBWI的临床资料进行回顾性分析,根据达到足量胃肠道内喂养的时间分为A组和B组,比较两组之间各项指标的差异.结果 24例ELBWI胎龄为(29.0±1.8)周(26.14~34.43周),出生体重为[(882±67)(730~970)]g,A组11例,达到足量喂养时间为(27±6)d;B组13例,达到足量喂养时间为(46±10)d.生后窒息(18.2%∶61.5%,P=0.047)、脐静脉插管时间长于10 d(18.2%∶61.5%,P=0.047)、机械通气时间长于14 d(27.3%∶76.9%,P=0.038)的比例,以及第21、28天的奶量[(88.9±35.4)ml:(37.4±34.9)ml,P=0.002;(121.1±37.4)ml:(53.2±33.1)ml,P=0.000]在两组间差异有统计学意义.胎龄、出生体重、动脉导管未闭、红细胞增多症、血糖异常、败血症、开奶日龄、开奶量、第1周加奶量、第2周加奶量、第3、7、14天奶量均无统计学差异.结论 窒息、脐静脉插管时间、机械通气时间可能影响ELBWI的胃肠道内喂养,喂养较顺利的ELBWI在生后第3周时即可表现出较好的耐受性.但因ELBWI的胃肠道内喂养可能受到多种因素的影响,在进行喂养时应针对不同情况制定个体化方案.
Abstract:
Objective To review the clinical data of enteral feeding of extremely low birth weight infants (ELBWI), and analyze the influencing factors. Method From Jan. 2000 to Jan. 2010, data of 31 ELBWI from Peking Union Medical College Hospital were retrospectively collected. ELBWI were assigned to different groups according to the time achieving full enteral feeding, comparison was done between two groups for enteral feeding. Result Twenty-four infants were analyzed, their mean gestational age was ( 29. 0 ±1.8) weeks (26. 14-34. 43 weeks), birth weight (882 ±67)g(730-970 g), there were 11 infants in group A, whose time for achieving full enteral feeding was (27 ±6)days, there were 13 infants in group B, whose time achieving full enteral feeding was ( 46 ± 10 ) days. The ratio of asphyxia ( 18.2% vs. 61.5%, P =0. 047 ), duration of umbilical vein catheterization longer than 10 days ( 18. 2% vs. 61.5%, P = 0. 047 ),and duration of mechanical ventilation longer than 14 days(27.3% vs. 76.9% ,P = 0. 038 )in group A was higher than in group B. The milk volume on the 21st and 28th day in group A was much more than that in groupB[(88.9±35.4)mlvs. (37.4±34.9) ml, P=0. 002;(121.1±37.4) ml vs. (53.2±33.1) ml,P =0. 000]. There were no significant differences between the two groups in gestational age, birth weight,patent ductus arterious, erythrocytosis, dysglycemia, sepsis, the time to begin enteral feeding, the beginning milk volume, the adding milk volume in the 1st, 2nd week, and the milk volume on the 3rd, 7th, 14th day.Conclusion Asphyxia, duration of umbilical vein catheterization, and duration of mechanical ventilation are likely to influence the enteral feeding of ELBWI, ELBWI with successful enteral feeding could show good tolerance in the 3rd week. But individual program should be made for enteral feeding of ELBWI, because enteral feeding could be influenced by multiple factors.  相似文献   

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