泰安市中心医院儿童大叶肺炎病原学特点及临床分析

Pathogenic and Clinical Analysis of Children's Lobar Pneumonia in Central Hospital of Tai'an City

目的通过分析儿童大叶肺炎的病原学特点、临床特征、治疗效果及预后指导临床工作。方法对2017年1月～12月入住泰安市中心医院儿内科的147例大叶肺炎患儿病原学特点、临床特征及诊疗过程进行分析。结果 (1)男性102例,女性45例,年龄4个月～13岁,平均年龄(3.47±4.17)岁,约占同期肺炎患儿的7.41%;全部病例均有咳嗽,伴发热占91.83%;(2)存在合并症共有27例,占18.37%,其中胸腔积液19例,胸膜炎24例,气胸1例;(3)CRP、白细胞计数升高各占33.33%、23.81%;肺炎支原体抗体阳性占78.91%,血白细胞内EB病毒-DNA阳性占55.10%;(4)治疗后发热平均持续时间(4.60±1.57)d,复查胸部CT 123例完全吸收(83.67%),平均住院(9.40±2.17)d。结论儿童大叶肺炎以学龄前及学龄期儿童为主,支原体感染占绝大多数,部分患儿合并细菌、EB病毒感染;症状不典型,多以发热为首发症状,体征不明显,并发症多,经正规抗感染治疗,患儿绝大多数均能痊愈。

Objective To guide clinical work by analyzing the etiology, clinical features, treatment effects and prognosis of children with lobar pneumonia. Methods The pathogenic characteristics, clinical features and diagnosis and treatment of 147 children with lobar pneumonia admitted to the Department of Pediatrics of Tai＇an Central Hospital from January to December 2017 were analyzed. Results ①Male 102 cases, female 45 cases, aged 4 months to 13 years, mean age （3.47±4.17） years old, accounting for 7.41% of children with pneumonia in the same period; all cases have cough, with fever accounted for 91.83%; ②There were 27 cases of comorbidities, accounting for 18.37%, including 19 cases of pleural effusion, 24 cases of pleurisy, 1 case of pneumothorax;③CRP, white blood cell count increased by 33.33%, 23.81%; Mycoplasma pneumoniae antibody accounted for 78.91%, blood Epstein-Barr virus-DNA positive in leukocytes accounted for 55.10%; ④Mean fever duration after treatment （4.60±1.57）d, 123 cases of chest CT were completely absorbed （83.67%）, and the average hospital stay （9.40±2.17）d. Conclusion Children with lobar pneumonia are mainly preschool and school-age children. Mycoplasma infection accounts for the majority. Some children have bacterial and EB virus infection. The symptoms are atypical. Most of them have fever as the first symptom, the signs are not obvious, and the complications are many. After regular anti-infective treatment, most of the children can be cured.