儿童塑型性支气管炎的临床预警因素分析

Analysis of the clinical early warning factors of the plastic bronchitis in children

目的分析儿童急性下呼吸道感染后并发塑型性支气管炎的可能临床预警因素。方法回顾性分析2017年12月至2021年1月该院呼吸科144例急性下呼吸道感染患儿的临床资料,根据是否并发塑型性支气管炎分成研究组(49例)和对照组(95例),比较两组临床资料,采用logistic回归模型分析儿童急性下呼吸道感染后并发塑型性支气管炎的可能临床预警因素。结果研究组气促、三凹征、听诊呼吸音降低、低氧血症、二氧化碳分压(PCO_(2))≥50 mm Hg、腺病毒感染、肺不张患儿比例高于对照组,差异有统计学意义(P<0.05)。多因素logistic分析显示,气促(OR=3.641,95%CI:1.118~11.851)、低氧血症(OR=4.262,95%CI:1.299~13.980)、PCO_(2)≥50 mm Hg(OR=4.568,95%CI:1.529~13.727)可能为儿童急性下呼吸道感染后并发塑型性支气管炎的临床预警因素,且腺病毒感染(OR=3.325,95%CI:1.164~9.496)可能为其危险因素(P<0.05)。结论分析急性下呼吸道感染后并发塑型性支气管炎的预警因素,有助于诊断并改善预后。

Objective To analyze the possible clinical early warning factors of plastic bronchitis after acute lower respiratory tract infection in children.Methods The clinical data of 144 children with acute lower respiratory tract infection in the respiratory department of this hospital from December 2017 to January 2021 were analyzed retrospectively.According to the complication of plastic bronchitis,the patients were divided into the study group(n=49)and the control group(n=95).Logistic regression model was used to analyze the possible clinical early warning factors of the plastic bronchitis in the children with acute lower respiratory tract infection.Results The proportion of children with shortness of breath,triple concave sign,decreased breath sound during auscultation,hypoxemia,partial pressure of carbon dioxide(PCO_(2))≥50 mm Hg,adenovirus infection and atelectasis in the study group were significantly higher than those in the control group(P<0.05).Multivariate logistic analysis showed that the shortness of breath(OR=3.641,95%CI:1.118-11.851),hypoxemia(OR=4.262,95%CI:1.299-13.980)and PCO_(2)≥50 mm Hg(OR=4.568,95%CI:1.529-13.727)may be the clinical early warning factors of the plastic bronchitis after the acute lower respiratory tract infection in children,and adenovirus infection(OR=3.325,95%CI:1.164-9.496)may be a risk factor(P<0.05).Conclusion The analysis of the early warning factors of the plastic bronchitis after acute lower respiratory tract infection is helpful to diagnose and improve the prognosis.