新生儿社区感染性肺炎213例临床分析  

Clinical Analysis of 213 Neonates with Community-acquired Pneumonia

作　　者：刘华君[1] 许红波[1] 王太森[1] 刘文彬[1] 汤雪晴[1] 吕洁[1] 

机构地区：[1]中国人民解放军成都军区总医院儿科,成都610083

出　　处：《西南军医》2014年第5期501-503,共3页Journal of Military Surgeon in Southwest China

摘　　要：目的分析新生儿社区感染性肺炎的临床特点。方法对213例新生儿社区感染性肺炎的临床资料进行回顾性分析。结果 (1)临床表现和体征:气促173例,发绀128例,咳嗽137例,口吐白沫121例,发热86例,三凹征97例,肺部呼吸音粗87例,肺部闻及干湿啰音92例,黄疸95例。(2)病原学:痰培养阳性82例,其中革兰阴性杆菌64例。(3)感染指标:白细胞(WBC)升高108例,C反应蛋白升高40例,降钙素原升高87例。(4)X线胸片:双肺纹理增多、模糊,肺门影模糊137例,小点片状影31例。(5)心脏彩超检查有先心病116例。结论新生儿社区感染性肺炎的临床表现不典型,痰培养阳性率较低,感染指标特异性不高,X线胸片大多有改变,合并先心病的患儿患社区感染性肺炎的比例明显较高,因此诊断和治疗时需进行综合考虑。Objective To analyze the clinical features of neonatal community-acquired pneumonia （CAP）. Methods A retrospective analysis was made to the clinical data of 213 neonates with CAP. Results Clinical manifestations and physical signs： dyspnea was found in 173 ccases, cyanosis in 128 cases, cough in 137 cases, buccal foam in 121 cases, fever in 86 cases, three depression sign in 97 cases, crude breath in 87 cases, rales or rhonchi in 92 cases and jaundice in 95 cases;etiological study：out of 82 positive cases of spu-tum culture, there were 64 cases with Gram-positive bacteria;infection index：WBC increase was found in 108 cases, C-reactive pro-tein increase in 40 cases and procalcitionin （ PCT ） increase in 87 cases;chest X-ray findings：increased blur imaging of lung-marking and hilar was found in 137 cases and images of dotted flake shadows in 31 cases;cardiac color ultrasound indicated congenital heart dis-ease （CHD）） in 116 cases. Conclusions The clinical manifestations of neonatal CAP are atypical with low positive rate of sputum cul-ture, weak specificity and more changes in chest X-ray, the rate of CHD complication is obviously higher, which should be taken into consideration while making diagnosis and treatment.

关 键 词：新生儿 社区感染性肺炎 病原学 X线胸片 

分 类 号：R563.1[医药卫生—呼吸系统]