足月新生儿呼吸道合胞病毒肺炎临床特征  

Clinical features of full-term neonates with respiratory syncytial virus pneumonia

作　　者：杨慧[1] 黄惠君[1] 何柳芳[1] 余珍珠[1] 冯雪[1] 高镝[1] 

机构地区：[1]深圳市儿童医院新生儿科,518000

出　　处：《中国小儿急救医学》2015年第11期783-786,共4页Chinese Pediatric Emergency Medicine

摘　　要：目的探讨新生儿呼吸道合胞病毒（respiratorysyncytialvirus，RSV）肺炎的临床特点。方法收集本院2014年1月至2015年1月确诊为新生儿肺炎的足月儿422例，应用直接免疫荧光法检测其RSV抗原，根据检测结果分为RSV阳性组和RSV阴性组，对两组患儿临床资料进行分析。结果RSV阳性45例，RSV阴性377例。RSV阳性组及阴性组母乳喂养比例分别为42．22％及65．25％，阴道分娩在两组中所占比例分别为20．00％及76．12％，差异均有统计学意义。而两组在入院体重、住院时间、出生胎龄、入院年龄上差异均无统计学意义。RSV阳性组咳嗽（100％）、呼吸急促（88．89％）、三凹征（48．89％）、细湿性哕音（66．67％）及喘鸣音（22．22％）的发生率均高于RSV阴性组，RSV阴性组分别为84．88％、42．44％、13．26％、13．53％、3．98％，差异有统计学意义；而发热、吐沫、鼻塞的发生率两组差异无统计学意义。两组在x线胸片表现上差异有统计学意义，RSV阳性组更多的表现为肺气肿，两组有肺气肿表现分别为71．11％和6．90％；RSV阴性组更多的表现为肺斑片影，两组有肺斑片影表现分别为88．89％和93．10％，而在血常规、C反应蛋白、呼吸衰竭、痰培养阳性率、合并气胸、胸腔积液方面差异无统计学意义。结论RSV是足月新生儿感染性肺炎的重要病原之一。母乳喂养及顺产可减少新生儿感染RSV的风险。RSV肺炎在临床表现上更易出现咳嗽、呼吸急促及肺部哕音，x线胸片更易出现肺气肿表现。Objective To explore the clinical features of respiratory syncytial virus（RSV） pneumonia in full-term neonatal patients. Methods All 422 full-term newborns diagnosed as pneumonia in NICU of Shenzhen Children＇s Hospital during January 2014 to January 2015 were included in this study. They had been detected for RSV in the way of direct immunofluorescence assay. According to the detection results ,they were divided into RSV positive group and RSV negative group, the clinical data in two groups were analyzed. Results Forty-five cases were RSV positive ,377 cases were RSV negative. The proportion of breast feeding was 42. 22% vs. 65.25% ,the proportion of cesarean section was 20.00% vs. 76. 12% in two groups,there were significant differences between the two groups. Hospitalization time, birth weight, gestational age, the age of admission showed no difference between two groups. The incidencs of cough （ 100% ）, shortness of breath（88. 89% ） ,three depressions（48.89% ） ,fine rales （66. 67% ）, wheezing （22. 22% ） in RSV positive group were higher than those in the RSV negative group（ 84. 88% ,42.44%, 13.26%, 13.53% ,3.98% re- spectively）, there were significant differences between the two groups. The incidences of fever, saliva, nasal showed no significant difference between the two groups. There was significant difference in the X-ray chest film performance between two groups, RSV positive group was more emhrysema（ 71.11% vs. 6. 9% ）, and less patch shadow（88.89% vs. 93.10% ）. The laboratory examination of blood routine test,C-reactive pro- tein,respiratory failure, the positive rate of sputum culture, pneumothorax, pleural effusion were without differences. Conclusion RSV is an important pathogen of full-term neonates with infectious pneumonia. Breastfeeding and eutocia can reduce the incidence of RSV infection. Cough, shortness of breath, pulmonary rales, and emphysema in X-ray were common in RSV pneumonia.

关 键 词：呼吸道合胞病毒 肺炎 新生儿 

分 类 号：R722.135[医药卫生—儿科]