重症甲流患儿的临床特点及诊疗体会  

Clinical features and treatment experience of severe influenza in children

作　　者：王丹 王瑾 赵丽 孙晓 周东元 任立红[2] Dan WANG;Jin WANG;Li ZHAO;Xiao SUN;Dongyuan ZHOU;Lihong REN(Department of Critical Care Medicine, Harbin Children's Hospital, Harbin 150000, China;Department of Pediatrics,the Second Affiliated Clinical Medical College of Harbin Medical University, Harbin 150000, China)

机构地区：[1]哈尔滨市儿童医院重症医学科,黑龙江哈尔滨150000 [2]哈尔滨医科大学附属第二临床医学院儿科,黑龙江哈尔滨150000

出　　处：《临床检验杂志（电子版）》2017年第2期159-160,共2页Clinical Laboratory Journal(Electronic Edition)

摘　　要：目的对重症甲型H1N1流感患儿的临床特点、诊断与治疗方法以及病情转归等情况进行探究。方法选取我院2015年10月-2016年11月10例甲型H1N1流感重症患儿为研究对象,对其进行隔离治疗,将其一般情况、流行病学、临床表现、影像学检查、实验室检查结果、并发症及治疗方案、预后等各方面资料进行研究分析。结果重症甲型H1N1流感的临床特点为咳嗽、发热;对患儿进行奥司他韦抗病毒治疗,疗程5 d-10 d;同时给予丙种球蛋白免疫支持,有5例患儿体温在3 d内恢复正常,2例患儿体温在5 d内恢复正常,3例患儿体温在1周后恢复正常,最终所有患儿均临床治愈。结论危重症甲流特点:(1)绝大多数临床表现与细菌引起的重症肺炎相似,不易区分;(2)化验检查多提示细菌感染,病毒感染易被掩盖;(3)病情进展快,肺炎病灶广泛,易出现多脏器受累。故对该病的早期识别、早期给予大剂量丙种球蛋白(3 g/kg)免疫支持及奥司他韦抗病毒治疗尤为重要,其效果显著,安全性高,在临床上值得广泛推广。Objective The clinical characteristics of children with severe H1N1influenza infection,diagnosis andtreatment methods and prognosis were explored.Methods In our hospital from October2015to November2016,10cases ofchildren with severe influenza a H1N1as the research object,carries on the isolation and treatment,the general situation,epidemiology,clinical manifestations,imaging inspection,laboratory examination results,complications and treatment,the prognosisof data were analyzed.Results The clinical features of severe influenza a H1N1were cough,fever;Of oseltamivir for antiviraltherapy for children with a course of5-10days;while giving the gamma globulin immune support,5cases of children with normalbody temperature recovery in three days,2cases of children with normal body temperature recovery in5days,3cases ofchildren with normal body temperature recovery in1week after the final,all patients were clinically cured.Conclusion Criticallyill features:(1)The vast majority of clinical manifestations are similar to those of bacterial pneumonia,which are difficultto distinguish;(2)Laboratory tests are usually suggestive of bacterial infection,and viral infections can be easily masked;(3)Thecondition is rapid,the pneumonia has a wide range of lesions and is prone to multiple organ involvement.Early identificationof the disease,early administration of large dose of gamma globulin(3g/kg)and oseltamivir treatment is particularly important.Its significant effect,with high safety,which is worthy of clinical application.

关 键 词：临床特点 治疗方法 甲型H1N1流感 重症 儿童 

分 类 号：R725.1[医药卫生—儿科]