83例重症甲型流行性感冒患儿的临床特征

目的探讨儿童重症甲型流行性感冒的临床特征。方法收集首都医科大学附属北京地坛医院儿科83例重症甲型流行性感冒患儿的临床资料,对其性别、年龄、持续发热时间、并发症及预后进行回顾性描述分析。结果83例重症甲型流行性感冒患儿中,男43例(51.81%)、女40例(48.19%),平均发病年龄(2.43±1.5)岁。83例患儿均伴有发热,平均发热最高峰为(39.72±0.77)℃,平均发热时间为(3.02±2.35)d。并发症:呼吸系统51例(61.45%),神经系统31例(37.35%),循环系统23例(27.71%),消化系统14例(16.87%),血液系统29例(34.94%);伴其他并发症(电解质紊乱)患者15例(18.07%)。合并感染:细菌感染者24例(28.91%),支原体感染者22例(26.50%),其他病毒感染者16例(19.28%),真菌感染者1例(1.20%)。入组患儿均给予神经氨酶抑制剂及对症支持治疗的综合治疗,其中2例患儿自动出院(病情好转),81例均治愈出院。入组患儿平均住院天数为(5.80±3.12)d,其中非合并肺炎患儿平均住院天数为(5.45±2.87)d,而合并肺炎患儿平均住院天数为(7.31±2.85)d,最长者达23 d。结论儿童重症甲型流行性感冒多发生于5岁以下儿童,尤其以3~4岁多见,以呼吸系统并发症多见,且住院时间长的病例亦多见于合并肺炎并发症者,易并发多种、多重病原体感染。甲型流感病毒对儿童健康危害大,但经积极治疗预后良好。应加强对重症甲型流行性感冒的认识,做到早诊断、早治疗,尽量减少疾病危害,提高早期治愈率。

Clinical characteristics of 83 children with severe influenza A

Objective To investigate the clinical characteristics of severe influenza A in children.Methods The clinical data of 83 children with severe influenza A in Department of Pediatric,Beijing Ditan Hospital,Capital Medical University were collected,the data of sex,age,duration of fever,complications and prognosis were analyzed,retrospectively.Results Among the 83 children with severe influenza A,43 cases(51.81%)were male and 40 cases(48.19%)were female,with an average age for(2.43±1.5)years old.All 83 children had fever,with the mean highest peak of fever for(39.72±0.77)℃and the mean fever time was(3.02±2.35)d.There were 51 cases(61.45%)with respiratory system complications,31 cases(37.35%)with nervous system complications,23 cases(27.71%)with circulatory system complications,14 cases(16.87%)with digestive system complications,29 cases(34.94%)with blood system complications;15 cases(18.07%)with other complications(electrolyte disturbance).Co-infection:there were 24 cases(28.91%)with bacterial infection,22 cases(26.50%)with mycoplasma infection,16 cases(19.28%)with viral infection and 1 case(1.20%)with fungal infection.All 83 children were treated with neuraminidase inhibitor and symptomatic support therapy,among whom,2 cases discharged automatically(state improved)and 81 cases were cured and discharged.The average hospitalization days of 83 caese were(5.80±3.12)d,among whom,the average hospitalization days of cases with non-pneumonia was(5.45±2.87)d,while cases with pneumonia were(5.45±2.87)d,and the maximum was 23 d.Conclusions Severe influenza A occur mostly in children under 5 years old,especially in children with 3-4 years old,commonly with respiratory complications,cases with pneumonia complications commonly had long hospitalization period,and were susceptible to various or multiple pathogen infection.Severe influenza A had great negative impact on children’s health,but with good prognosis through active treatment.It was necessary to strengthen the understanding of severe influenza A,make early diagnosis and treatment,minimize the harm of disease and improve the rate of early cure.