新生儿和小婴儿Ⅲ型副流感病毒肺炎55例

Clinical Analysis of 55 Cases of Neonates and Small Infants with Parainfluenza Virus Ⅲ Pneumonia

目的探讨新生儿和小婴儿Ⅲ型副流感病毒（PIV3）肺炎的临床特点，提高对该病的诊治水平。方法2005年8月-2007年7月依据肺炎临床诊断标准和实验室间接免疫荧光法诊断并住院治疗的新生儿和小婴儿PIV3肺炎55例，对该组患儿的临床特点进行回顾性分析，包括患儿的性别、年龄、症状、体征、肺部X线特点、实验室检查结果、治疗情况及预后等。结果肺炎患儿55例中小婴儿占80％（44／55例），新生儿占20％（11／55例）。季节分布以春夏最多。城郊病例占74．5％（41／55例），城区病例占25，5％（14／55例）。均有咳嗽，刺激性咳嗽或痉挛性咳嗽34例（61．8％），咳嗽同时呛奶39例（70．9％）；发热26例（47．3％），多为短期轻度发热；喘息14例（25．5％）。肺部细湿哕音20例，其中伴喘鸣8例，有喘鸣音无湿啰音6例，肺部呼吸音粗伴痰鸣音21例。肺外表现主要有轻度吐奶、腹泻；胸片示右肺受累18例，左肺2例，双肺35例。病程1～2周16例，〉2～3周28例，〉3周11例，病程最长者32d。55例患儿中42例（76．4％）未使用抗生素，患儿均未接受抗病毒治疗。55例均临床痊愈出院，其中35例出院2周内随访，未见到肺部严重受损。结论春夏是新生儿和小婴儿PIV3肺炎发病高峰，病程长，临床表现为刺激性咳嗽，右肺易受累，并发症少是其主要特征，临床特点和实验室检查相结合有利于准确诊断和治疗。

Objective To explore the clinical characteristics of neonatal and small infants with parainfluenza virus m （PIV3） pneumonia. Methods . According to the clinical diagnosis criteria and the indirect immuno - fluorescent assay, there were 55 neonates and small infants who were diagnosed as PIV3 pneumonia in our hospital from Aug. 2005 to Jul. 2007. Their clinical data, such as their incidences, symptoms, signs, chest X -ray presentations, laboratory evaluation, therapy and prognosis were studied respectively. Results The 55 cases were com- posed by 80% （44/55 cases） small infants and 20% （ l 1/55 cases） neonates. In spring and summer,the incidence rate was higher than that in other seasons. The cases of suburb（74.5% ） were much more than that of rural area （25.5%）. Twenty cases bellows appeared fine rales, combined stridor 8 cases ,6 cases appeared stridormerely. Twenty - one bellows respiratory sound cruded and combined wheezy phlegm. All the cases were suffered from cough. Among the 55 cases,there were 34 cases had spasm cough,39 had feeding cough,26 had fever, 14 cases had wheeze. Their extra lung presentations were slight diarrhea ,vomiting. Their chest X - ray film showed that there were 18 cases with their right lung involved,2 cases left lung,and 35 cases with both side involved. All the cases had duration longer than 1 week, 16 cases were 1 -2 weeks,28 cases were 〉 2 - 3 weeks, 11 cases were 〉 3 weeks. Among them,42 cases（76.4% ） did not received antibiotics. All the patients did not get any drugs concerned with virus treatment. These 55 cases recovered well. Thirty - five of them were followed for 2 weeks, and no lung injury was detected. Conclusions The neonates and small infants pneumonia caused by PIV3 tends to occur in spring and summer. Its duration is long and severe cough is prominent. The right lung or both side are likely to be involved. Its complication is few. The clinical characteristics and laboratory characteristics should be analyzed together to make correct diagnosis and treatment.