新生儿呼吸道合胞病毒感染临床特征与治疗转归

Clinical Characteristics and Treatment Outcome of Neonatal Respiratory Syncytial Virus Infection

目的 探讨新生儿呼吸道合胞病毒(RSV)感染临床特征与治疗转归效果。方法 回顾分析2017年11月-2021年10月罗定市人民医院收治的30例感染RSV的新生儿病例资料,分析临床表现及治疗转归情况,并比较单纯RSV感染和合并细菌感染的差别。结果 30例新生儿均为下呼吸道感染(ALRTI),主要临床表现是咳嗽(100.00%)、气促(76.67%)、呛奶(66.67%)、吐沫(66.67%)和鼻塞流涕(63.33%),主要临床体征是痰鸣音(73.33%)、细湿啰音(66.67%)和喘鸣音(63.33%),主要并发症是Ⅰ型急性呼吸衰竭(36.67%)和Ⅱ型急性呼吸衰竭(23.33%)。经过治疗,所有患儿均治愈出院。RSV合并细菌感染患儿发热、吸氧/通气治疗、喘息、细湿啰音占比分别为50.00%、80.00%、100.00%和100.00%,显著高于单纯RSV感染患儿发热、吸氧/通气治疗、喘息、细湿啰音占比10.00%、25.00%、45.00%和50.00%,差异有统计学意义(P<0.05)。RSV合并细菌感染患儿平均住院时间为(10.80±2.35)d,比单纯RSV感染患儿住院时间(6.50±1.28)d长,差异有统计学意义(P<0.05)。结论 新生儿感染RSV临床表现不典型,与单纯RSV感染相比,合并细菌感染病情更重,应尽早干预和治疗。

Objective To explore the clinical characteristics and treatment outcome of neonatal respiratory syncytial virus (RSV) infection.Methods To retrospectively analyze the data of 30 cases of RSV-infected newborns admitted to our hospital from November 2017 to October 2021,the clinical manifestations and treatment outcomes,and the differences between simple RSV infection and combined bacterial infection.Results The 30 newborns were all lower respiratory tract infections (ALRTI),the main clinical manifestations were cough (100.00%),shortness of breath (76.67%),choking (66.67%),spitting (66.67%) and nasal congestion and runny nose (63.33%).The main clinical signs are phlegm sounds (73.33%),thin moist rales (66.67%) and stuffy running nose (63.33%).The main complications are type I acute respiratory failure (36.67%) and type II acute respiratory failure (23.33%).After treatment,all children were cured and discharged.The proportions of fever,oxygen inhalation/ventilation treatment,wheezing,and moist rales in RSV patients with bacterial infection were 50.00%,80.00%,100.00%,and 100.00%,respectively,which were significantly higher than those in children with RSV infection alone.Treatment,wheezing,and fine moist rales accounted for 10.00%,25.00%,45.00% and 50.00%,and the difference was statistically significant (P<0.05).The average hospital stay of children with RSV combined with bacterial infection was (10.80±2.35)d,which was longer than that of children with RSV infection alone (6.50±1.28)d,and the difference was statistically significant (P<0.05).Conclusion The clinical manifestations of neonatal infection with RSV are atypical.Compared with simple RSV infection,the condition of combined bacterial infection is more serious,and intervention and treatment should be carried out as soon as possible.