儿童慢性肺炎102例临床分析

Clinical analysis of 102 cases children with chronic pneumonia

目的分析儿童慢性肺炎的临床及病原学特点,寻找可能病因,协助诊治。方法回顾性分析2016年8月至2017年10月重庆医科大学附属儿童医院住院治疗的102例首次诊断为慢性肺炎患儿的临床资料。结果慢性肺炎多见于男性患儿,农村多于城市,无明显年龄、季节差异。年龄小于3岁患儿合并基础疾病以先天性气管支气管肺发育畸形常见,≥3岁患儿则以原发性免疫缺陷病更常见。各年龄段均以细菌感染,尤其是革兰阴性菌感染为主,年龄小于3岁患儿病毒感染率高于大于或等于3岁患儿,支原体感染在小于3岁患儿中并不少见。多数细菌对三代头孢及含酶抑制剂青霉素类抗生素较敏感,耐药率低于31.3%。结论基础疾病及感染是慢性肺炎发生的两大主要因素。年龄3岁及以上与3岁以下患儿合并基础疾病种类不同,感染均以细菌感染为主,首选抗生素为三代头孢或含酶抑制剂青霉素类。

Objective To analyze the clinical and etiological characteristics of chronic pneumonia in children,in order to look for possible etiology,to assist in diagnosis and treatment. Methods The clinical data of chronic pneumonia in the 102 cases children admitted to Children′s Hospital of Chongqing Medical University from August 2016 to October 2017 were retrospectively analyzed. Results Chronic pneumonia was more common in male or rural children,and there was no obvious difference between ages or onset reasons.Congenital tracheobronchial and pulmonary malformations were common in children younger than 3 years old with underlying diseases,and primary immunodeficiency was more common in children older than 3 years old.All ages were dominated by bacterial infection,especially gram-negative bacterial infection.The viral infection rate in children younger than 3 years was higher than or equal to 3 years old,and mycoplasma infection was not uncommon in children younger than 3 years old.Most bacteria were sensitive to the third-generation cephalosporin or penicillin containing enzyme inhibitors,the rate of drug-resistant was less than 31.3%. Conclusion The underlying diseases and infectious agents are the two major factors of chronic pneumonia.The underlying diseases are different in children under and over 3-year-old,while bacterial infections are in the majority in both,and the first choice of antibiotics is the third-generation cephalosporin or penicillin containing enzyme inhibitors.