轮状病毒感染多器官损害的临床分析

目的：总结并进-步了解小儿轮状病毒感染致病临床特点，分析其对肠外多器官损害的表现。方法：回顾分析东莞市莞城厌院儿科2006年1月-2008年12月住院的轮状病毒肠炎患儿发病年龄、发病季节、症状、体征、水电解质和酸碱平衡、肠外脏器如肝脏、心脏、肾脏及神经系统的损害。结果：本组轮状病毒感染共456例。发病高峰为11月中旬～12月底，共375例（82．2％），高发年龄段为6个月-2岁，共387例（84．7％）。456例100％出现腹泻水样便或蛋花汤样便．所有患儿出现不同程度脱水．伴呕吐390例（85．5％），伴发热385例（84．45％）。肠外并发症265例（58．1％），合并2个或以上器官损害223例（48．9％），大便常规镜检均未见红细胞、白细胞，多见脂肪球256例，占56．1％，极少数见真菌。经合理补液及纠正电解质及酸碱紊乱，微生态疗法，忌双糖饮食及抗病毒治疗，有效率达100％．无一例死亡。结论：广东省东莞市小儿轮状病毒性肠炎多发于初冬，以6～24个月婴儿发病率最高，主要临床表现为发热、呕吐、腹泻水样或蛋花汤样便、脱水。多为等渗性脱水。大便常规无红细胞、白细胞，以脂肪球多见。除肠道外．还有不同程度肠外器官损害．病程多为7～10d，经合理治疗预后良好。

Clinical analysis of the disfunctions of mutiple-organs caused by rotavirus inflection

Objective： Summary the characteristics of rotavirus infection in infants for further understanding of the clinical features, especial the manifestations of disfunctions of organs extra-intestines.Methods： Retrospectivly analyzed the hospitalized cases from Jan 2006 to Dec 2008 in Guancheng hospital. To study clinical manifestations and analyze the complications extra-intestines.Results： 456 cases were included and 387 cases were infants from 6-month to 2-year old（8d.7%）. Onset peak was from middle of November to end of December（375 cases, 82.2%）. Diarrhea with watery stools was 456 cases（100%） with the stools a little white, dehydration was seen in all cases;vomiting was seen in 390 cases （85.5%）,fever was commomly seen （385 cases, 84.45%）, Complications extra-intestine occurred in 265 cases （58.1%）. And in some cases at least two organs were involved （223 cases, 48.9%）. Routine microscopy test of stools showed that oil globules were eazily seen （265 cases,58.1%） but fungus were less seen and red cells, white cells were hardly seen. No death occurred after reasonabl fluid infusion, retrieving electrolytes and acid base disorder, micro-ecosystem therapy, disaccharose prohibiting and anti-virus therapy. Conclusion： Rotavirus infections easily occur in infants in early winter. The highest incidence of infant is 6 to 24 months clinical manifestations include fever, vomiting and diarrhea with watery stools. Dehydration is isotonic. oil globules are commomly seen but pus cells and RBCs are hardly seen in routine microscopy test of stools. Complications can occur in organs extra-intestine. The course of the disease is 7 to 10 days. All case rognosis bona after rational therapy.