儿童重症水痘的临床特点和治疗分析  

Clinical characteristics of intensive chicken pox in children and the treatment

作　　者：姚婷新[1] 廖亦男[1] 谷芬[1] 于四景[1] YAO Tingxin;LIAO Yinan;GU Fen;YU Sijing(Department of Infectious Diseases,Hunan Children's Hospital,Changsha 410007,China)

机构地区：[1]湖南省儿童医院感染科,长沙410007

出　　处：《中国中西医结合儿科学》2017年第6期483-485,共3页Chinese Pediatrics of Integrated Traditional and Western Medicine

摘　　要：目的探究儿童重症水痘的临床特点及有效治疗方法,为临床工作提供依据。方法选择2015年2月至2017年2月湖南省儿童医院感染科收治的重症水痘患儿98例,分析其临床资料。结果 (1)病因分析:有水痘患儿接触史占91.84%(90/98),有带状疱疹患儿接触史6.12%(6/98),病因不明2.04%(2/98)。(2)临床表现:98例患儿均有高热、乏力、嗜睡的症状,其中出现全身皮肤疱疹占68.37%(67/98),消化道症状占57.14%(56/98),咳嗽占66.33%(65/98),肌肉酸痛占20.41%(20/98),抽搐占11.22%(11/98),眼睑结膜疱疹占59.18%(58/98),口腔疱疹占43.88%(43/98),外阴部疱疹占27.55%(27/98)。(3)实验室检查结果:白细胞数、中性粒细胞百分比、血小板数目明显降低,而淋巴细胞百分比、C反应蛋白、乳酸脱氢酶、天冬氨酸转移酶、血肌酐、尿素氮含量均增高。(4)并发症情况:并发肺部细菌感染94.90%(93/98),并发肝损伤占91.84%(90/98),并发脑炎占83.67%(82/98),并发血小板减少占54.08%(53/98),并发心肌炎占42.86%(42/98)。(5)预后:98例患儿中有2例因长期服用糖皮质激素,血小板降低,最终多器官功能衰竭死亡,其余96例患儿痊愈。结论重症水痘的病情较为复杂,除了高热、乏力、嗜睡外,全身皮肤疱疹、咳嗽为最常见临床表现,常累及肝脏和肺,治疗中应恰当用药并警惕并发症的发生。Objective To explore the clinical characteristics of children's intensive chicken pox and its effective treatment method,providing the basis for clinical work.Methods A total of98children with intensive chicken pox were chosen,who were treated in Hunan Children's Hospital from Fe.2015to Feb.2017,and their clinical data were analyzed Results(1)Cause analysis:about91.84%(90/98)children had contact with children with chicken pox;about61.2%(6/98)children had contact with children with herpes zoster,20.4%(2/98)with unknown cause.(2)Clinical manifestations:all the98cases of children had a high fever,fatigue and sleepiness,including skin sores(68.37%,67/98),gastrointestinal(57.14%,56/98),cough(66.33%,65/98),muscle pain(20.41%,20/98),tic(11.22%,11/98),palpebral conjunctiva herpes(59.18%,58/98),oral herpes(4388%,43/98)and genital herpes(27.55%,27/98).(3)Laboratory results:white blood cell count,neutrophil percentage and number of platelets were decreased obviously,while lymphocyte percentage,C reactive protein,lactate dehydrogenase,aspartate transaminase,serum creatinine and blood urea nitrogen content were higher.(4)Complications:94.90%(93/98)of the children had pulmonary bacterial infections;liver injury occurred in91.84%(90/98)of the children,encephalitis in83.67%(82/98),thrombocytopenia in54.08%(53/98),and myocarditis in42.86%(42/98).(5)Prognosis:Two out of98children died due to long term use of glucocorticoid and reduced platelet,which resulted in multiple organ failure,while the other96children recovered.Conclusion The condition of intensive chicken pox is relatively complex;in addition to high fever,fatigue and sleepiness,skin sores and cough are the most common clinical manifestations,which often involves the liver and lungs;treatment should focus on proper medication and be alert to the occurrence of complications.

关 键 词：重症水痘 病因 实验室检查 治疗 儿童 

分 类 号：R725.1[医药卫生—儿科]