支气管肺炎合并胃扭转临床特征分析  

Clinical features of infantile bronchial pneumonia complicated with gastric volvulus

作　　者：周菁[1] 郝创利[1] 王宇清[1] 范丽萍[1] ZHOU Jing;HAO Chuang-li;WANG Yu-qing;FAN Li-ping(Children’s Hospital of Soochow University,Suzhou,Jiangsu　215003,China)

机构地区：[1]苏州大学附属儿童医院,江苏苏州215003

出　　处：《临床肺科杂志》2018年第5期894-897,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的分析支气管肺炎合并胃扭转的临床特征。方法选取2009年1月-2012年11月住院的明确诊断婴儿支气管肺炎、上消化道钡餐(GI)明确胃扭转132例,同时选取同期住院婴儿支气管肺炎、GI为阴性48例患儿为对照组。分析两组患儿的临床、实验室检查资料和影像学的表现。结果 (1)132例婴儿支气管肺炎合并胃扭转与对照组相比,多发生于3月(2.64±1.70月),住院前病程较长(10天),住院时间延长,临床表现多样,奶后呛咳达23.3%,器官轴型占100%;(2)胃扭转致胃食管返流是触发因素,给予正规体位治疗可快速缓解支气管肺炎病情,无手术病例。结论婴儿支气管肺炎合并胃扭转多发生于3月大婴儿,是婴儿肺炎病程迁延难治的原因之一,奶后呛咳是其特征表现,体位疗法可取得满意疗效。Objective To explore the clinical characteristics of bronchial pneumonia complicated with gastric volvulus in infants.Methods A total of 132 infants with bronchial pneumonia and gastric volvulus hospitalized in the Children Hospital of Soochow University from January 2009 to November 2012 were enrolled in the study.Gastric volvulus was diagnosed by barium upper gastrointestinal series(GI).48 cases with the diagnosis of bronchial pneumonia at the same period were selected as controls.The clinical,laboratory data and radiographic findings of the two groups were analyzed.Results Bronchial pneumonia complicated with gastric volvulus mostly occurred in infants aged 2.64±1.70 months.Compared to the controls,they had a longer clinical course before hospitalization(10 days,5.5 days,respectively,P<0.001)and a longer hospital stay(8.11±3.10 days,7.63±2.46 days,respectively,P=0.042).They presented diverse respiratory manifestations,such as digestive tract symptoms complicated with vomiting(50.4%)and cough after feeding(23.3%).All patients were organoaxial gastric vovulus.Gastricesophageal reflux was the trigger of cough and it could be relieved by the right position in patients with unsatisfactory effect of antibiotics treatment.No operation was carried out in the study.Conclusion Gastric volvulus plays an important role in infants with recurrent bronchial pneumonia with diverse respiratory manifestations and could be relieved by position.

关 键 词：支气管肺炎 胃扭转 婴儿 

分 类 号：R725.6[医药卫生—儿科]