天津地区儿童甲型H1N1流感病例回顾性分析  

A Retrospective Analysis of Influenza A (H1N1) in Children of Tianjin

作　　者：梅早仙[1] 吴琦[2] 杜钟珍[1] 刘国威[1] 叶静[1] 

机构地区：[1]天津市海河医院感染科,300350 [2]天津医科大学总医院呼吸科

出　　处：《天津医药》2010年第2期115-117,共3页Tianjin Medical Journal

摘　　要：目的:总结天津市7例儿童散发甲型H1N1流感病例的临床特点,为本病的诊治预防提供临床经验并评估预后。方法:回顾性分析2009年6月9日—9月21日我院收治的儿童甲型H1N1流感确诊病例的临床资料、防护措施,并结合文献进行复习。结果:7例患儿中男4例,女3例,年龄1.5～13岁,中位年龄6岁。6例输入性病例,1例二代病例。主要症状均有发热、咳嗽,5例高热,3例伴咳痰;其他症状有乏力、头晕、头痛、流涕、喷嚏和咽痛咽痒。2例白细胞降低,2例合并感染者白细胞升高,3例正常。5例胸片正常,1例纹理紊乱,1例双肺呈渗出性片状影。7例均于起病2d内经口咽拭子实时PCR(RT-PCR)甲型H1N1流感病毒核酸检测阳性,在病程第5～9天阴转。6例奥司他韦治疗5d,1例病毒合剂治疗5d。平均住院7.9d,均症状消失治愈出院。在非直接暴露的情况下家属和医护人员均未被传染。结论:7例患儿主要症状为发热、咳嗽,平均病程9.1d,均治愈,本病可控可防可治。Objective：To summarize the clinical characteristics of 7 sporadic cases in children of influenza A （H1N1） broken out in Tianjin,and to provide clinical experience and prognosis factors for the diagnosis and prevention of this disease.Methods：The clinical data and protective measures were retrospectively analyzed in 7 children with H1N1 confirmed by Tianjin Haihe Hospital from June 9,2009 to September 21,2009,and the related literatures were reviewed.Results：There were six imported cases of H1N1 and one second-generation case.Fever and cough were the main symptom in children.There were 5 children with hyperpyrexia.Three were with expectoration.Other symptoms included anergy,dizziness,headache,nasal discharge,sneeze and pharyngalgia.Two of these children were with leukocytosis decrease,two were with infection of leukocytosis,and others were normal.Five of these children were with normal chest X-ray,one with texture disorder,and one with bilateral multiple infiltrating image.The positive influenza A virus result was detected by real-time PCR and sequencing comparison in the throat swab samples taken within 2 days from the seven children,and became negative after 5-9 days in the course of this disease.Six patients were accepted oseltamivir treatment for 5 days.One was treated only with anti-virus mixture.The average length of hospital stay was 7.9 days.When the children were discharged from hospital,all the symptoms were disappeared.All the patients＇ families,doctors and nurses were not infected in non-directly exposed to the disease.Conclusion：The seven child patients showed mainly symptoms of fever and cough.The average course was 9.1 days,and they were all cured.Therefore,influenza A （H1N1） is preventable and curable.

关 键 词：儿童 体征和症状 治疗 综合预防 甲型H1N1流感 

分 类 号：R511.7[医药卫生—内科学]