儿童甲型H1N1流行性感冒83例确诊病例临床分析

Clinical Analysis of 83 children with novel influenza A(H1N1) virus infection

目的:总结儿童甲型H1N1流行性感冒(流感)的临床特征及治疗经验。方法:回顾分析2009年8月8日-11月2日在北京甲流定点治疗医院发热病房隔离治疗并达到出院标准的83例甲型H1Nl流感确诊患儿的流行特征、临床特点及疗效。结果:83例患儿均为北京市各中小学学生,其中64例无明确密切接触史,但其学校出现过甲流感染病例。4例为输入性病例,13例有明确的甲流密切接触史。患儿的主要临床症状有发热95.1%、咳嗽82.7%、咳痰39.7%、流涕27.7%,咽痛25.3%、肌肉酸痛1.2%、头晕、头痛2.4%。部分患儿出现胆固醇、直接胆红素、乳酸脱氢酶等轻度异常,极少数患儿出现轻度转氨酶及心肌酶异常。治疗均参照中国国家卫生部颁布的《甲型H1N1流感诊疗方案》进行治疗。治疗后均达到出院标准,病毒核酸检测连续2次阴性,距出现首发症状的时间4～14d,住院时间2～11d。结论:新型甲型HlNl流感大部分症状轻微、病程较短;只有少部分可出现喘憋、呼吸困难及缺氧等严重合并症,但如无严重基础疾病,患儿均能治愈,预后良好。

Objective:The present study to review the clinical characteristics and treatment experience of H1 NI in uenza A,and suggest the clinical practices for the diagnosis and treatment of HI NI in uenza A in the future.Methods:Eighty three cases of Hl Nl in uenza A hospitalized in Beijing haidian Hospital from Auguest 8 to November 2.2009 were studied.Results:Eighty three cases came from the school of Beijing,aged from 6 to 13 years,48 of whom were boys,35 were girls.Four of them were imported cases,the 12 patients had a history of close contact H1N1 u patients.Else hadn`t close contact history,but in their school have had H1N1 u patients.The main symptoms of H1 N1 in uenza were fever(95.1%),cough(82.7%),cough with sputum(39.7%)and sore throat(25.3%),rhinorrhoea(27.7%),headache(2.4%),muscle pain(1.2%).And no body had vomiting or diarrhea.Some of them were tested out the mild increase of total cholesterol,direct bilirubin and LDH,And very few of them had little increase of ALT,AST and CK-MB.All of the 83 cases were discharged according to the Standard of Diagnosis and Treatment of Hl N1 In uenza A published by The Minister of Health.China.The period between 2 consecutive negative results in viral nucleic acid RT-PCR detection and the presenting symptom was 4 to 14 days and the period of hospitalization was 2 to 11 days.Conclusion:The majority of Hl NI in uenza A is characterized by mild symptoms,short period of hospitalization and good prognosis.Only some patients had several syndrome such as wheeze,dyspnoea and anoxemia etc.But all the patients can be cured,if they do not suffer from other severe chronic disease.