某院248例麻疹患儿的临床特征  

Clinical features of 248 children with measles in a hospital

作　　者：姚婷新[1] 谷芬[1] 廖亦男[1] 于四景[1] YAO Ting-xin;GU Fen;LIAO Yi-nan;YU Si-jing(Hunan Children’s Hospital,Changsha 410007,China)

机构地区：[1]湖南省儿童医院,湖南长沙410007

出　　处：《中国感染控制杂志》2018年第5期432-435,共4页Chinese Journal of Infection Control

摘　　要：目的分析某省儿童医院感染科麻疹患儿的临床特征,为临床诊治麻疹提供依据。方法回顾性分析2016年1月1日—6月30日某省儿童医院感染科确诊并住院治疗的麻疹患儿的人口学资料、临床特征、实验室检查结果及疾病的治疗和转归等。结果共调查248例麻疹患儿,平均年龄18.2月龄;其中≤9月龄组患儿98例,>9月龄组患儿150例;242例麻疹患儿未接种麻疹疫苗。83.06%麻疹患儿体温>39℃,平均热程为7.8 d;24例麻疹患儿表现为不典型皮疹。两组患儿主要并发症为肺炎,占93.95%;≤9月龄组患儿声嘶、呛咳、喉炎、心衰竭的发生率较>9月龄组患儿高(P<0.05);典型皮疹、柯氏斑、畏光流泪、呼吸衰竭、重症麻疹的发生率较>9月龄组患儿低(P<0.05);两组患儿治愈例数比较,差异无统计学意义(P>0.05)。248例麻疹患儿中有41例患儿外周血白细胞>10×109/L;合并肺炎的患儿痰培养检出病原菌以肺炎链球菌为主(28.26%);X线胸部平片检查报告以肺炎为主(93.95%);9例麻疹合并呼吸衰竭患儿,予有创呼吸机辅助治疗;其中6例好转出院,3例治疗无效死亡。结论 >9月龄未接种麻疹疫苗的患儿较多,易发生重症麻疹,而≤9月龄麻疹患儿易合并心衰竭。Objective To analyze clinical features of children with measles in the department of infectious disease in a children’s hospital,provide basis for clinical diagnosis and treatment of measles.Methods A retrospective analysis on demographic data,clinical features,laboratory examination,treatment,and prognosis of children with measles in a children’s hospital from January 1 to June 30,2016 were analyzed retrospectively.Results A total of 248 children with measles were investigated,the average age was 18.2 months;98 cases were aged≤9 months,150 were aged>9 months;242 children with measles didn’t receive measles vaccination.Body temperature of 83.06%of children with measles was>39℃,the average course of fever was 7.8 days;24 cases had atypical rash.Two groups of children were both mainly complicated with pneumonia,accounting for 93.95%;incidences of hoarseness,cough,laryngitis,and heart failure in children≤9 months were higher than children>9 months(P<0.05);while typical rash,koplik spots,photophobia,respiratory failure,and severe measles were lower than children>9 months(P<0.05);there was no significant difference in the number of cured cases between two groups of children(P>0.05).Of 248 children with measles,41 had peripheral white blood cells>10×10 9/L;28.26%of children who complicated with pneumonia were isolated Streptococcus pneumoniae from sputum;93.95%were reported pneumonia by chest X-ray examination;9 cases complicated with respiratory failure and used invasive mechanical ventilator,6 cases cured,3 died.Conclusion Children aged>9 months who don’t receive measles vaccine are more,and they are prone to develop severe measles,and children aged≤9 months are easily combined with heart failure.

关 键 词：麻疹 儿童 临床特征 麻疹疫苗 

分 类 号：R511.1[医药卫生—内科学]