重症肠道病毒感染患儿预后的临床表现及影响因素分析

Analysis of the Clinical Manifestation and Influencing Factors of Severe Enterovirus Infection in Children

目的:研究重症肠道病毒感染患儿预后临床表现及其影响因素。方法:回顾性分析2015年1月-2017年5月本院收治的重症肠道病毒感染患儿240例的临床资料。比较患儿临床症状、体征表现及治疗方式的选用情况,并分析影响预后的因素。结果:意识障碍患儿的治疗有效率为83.06%,低于无意识障碍患儿的97.41%(P<0.05);肢体冰凉、呼吸困难、心率加快患儿的治疗有效率均低于无肢体冰凉、无呼吸困难、无心率加快患儿(P<0.05);使用乌司他丁、未使用血管活性药、未使用机械通气的患儿治疗有效率均高于未使用乌他司丁、使用血管活性药、使用机械通气患儿(P<0.05);经多因素Logistic回归分析显示,意识障碍、心率加快、呼吸困难、血管活性药物及机械通气均为影响重症肠道病毒感染患儿预后的危险因素(P<0.05)。结论:临床应针对意识障碍、心率加快、呼吸困难的重症肠道病毒感染患儿制定有针对性的措施干预,同时可多使用乌司他丁治疗,改善患儿预后。

Objective:To study the clinical manifestation and influencing factors of severe enterovirus infection in children.Method:The clinical data of 240 children with severe enterovirus infection in our hospital from January 2015 to May 2017 were analyzed retrospectively.The clinical symptoms,signs and methods of treatment of children were compared and the factors affecting the prognosis were analyzed.Result:The effective rate of children with consciousness disorder was 83.06%,which was lower than unconsciousness children of 97.41%(P<0.05),the effective rate of children with cold limbs,dyspnea and heart rate acceleration were lower than those of without cold limbs,no dyspnea and no heart rate acceleration in children(P<0.05),the effective rate of children used ulinastatin,unused vasoactive drugs,and unused mechanical ventilation were higher than those of unused ulinastatin,used vasoactive drugs and mechanical ventilation in children(P<0.05).Multivariate Logistic regression analysis showed that disturbance of consciousness,heart rate acceleration,dyspnea,vasoactive drugs and mechanical ventilation were all risk factors for prognosis of severe enterovirus infection in children(P<0.05).Conclusion:Targeted interventions should be formulated for children with severe enterovirus infection,such as disturbance of consciousness,heart rate acceleration,and dyspnea,at the same time,can use the treatment of ulinastatin,improve the prognosis of children.