儿童2019冠状病毒病(COVID-19)诊疗指南(第二版)  

Diagnosis and treatment recommendation for pediatric COVID-19(the second edition)

作　　者：陈志敏[1] 傅君芬[1] 舒强[1] 汪伟[1] 陈英虎[1] 华春珍[1] 李甫棒[1] 林茹[1] 唐兰芳[1] 汪天林[1] 王颖硕[1] 徐玮泽[1] 杨子浩[1] 叶盛[1] 袁天明[1] 张晨美[1] 张园园[1] CHEN Zhimin;FU Junfen;SHU Qiang;WANG Wei;CHEN Yinghu;HUA Chunzhen;LI Fubang;LIN Ru;TANG Lanfang;WANG Tianlin;WANG Yingshuo;XU Weize;YANG Zihao;YE Sheng;YUAN Tianming;ZHANG Chenmei;ZHANG Yuanyuan(Children's Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,National Children's Regional Medical Center,Hangzhou 310052,China)

机构地区：[1]国家儿童健康与疾病临床医学研究中心、国家儿童区域医疗中心、浙江大学医学院附属儿童医院,浙江杭州310052

出　　处：《浙江大学学报（医学版）》2020年第2期139-146,共8页Journal of Zhejiang University(Medical Sciences)

基　　金：浙江大学新型冠状病毒(2019-nCov)肺炎应急科研专项(2020XGZX081).

摘　　要：严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染导致的2019冠状病毒病(COVID-19)已引起全球大流行。人群对SARS-CoV-2普遍易感,儿童也不例外,但病情相对较轻。与确诊或可疑COVID-19患者接触史或聚集性发病等流行病学证据及临床表现是COVID-19诊断的主要依据。儿童COVID-19多以发热、咳嗽为主要症状,血白细胞总数正常或减少,胸部影像学以间质性肺炎为特征,与其他呼吸道病毒感染及肺炎支原体感染相似,确诊有赖于实时荧光PCR等方法检测呼吸道标本病毒核酸。临床处理强调早识别、早隔离、早诊断及早治疗。轻型和普通型患儿以对症治疗为主;重型和危重型患儿应根据病情给予吸氧、抗病毒药物、抗菌药物、糖皮质激素、机械通气及体外膜氧合等治疗,严格掌握指征与时机,并通过多学科协作诊疗及时调整治疗方案。The coronavirus disease 2019(COVID-19)has caused a global pandemic.All people including children are generally susceptible to COVID-19,but the condition is relatively mild for children.The diagnosis of COVID-19 is largely based on the epidemiological evidence and clinical manifestations,and confirmed by positive detection of virus nucleic acid in respiratory samples.The main symptoms of COVID-19 in children are fever and cough;the total number of white blood cell count is usually normal or decreased;the chest imaging is characterized by interstitial pneumonia,which is similar to other respiratory virus infections and Mycoplasma pneumoniae infections.Early identification,early isolation,early diagnosis and early treatment are important for clinical management.The treatment of mild or moderate type of child COVID-19 is mainly symptomatic.For severe and critical ill cases,the oxygen therapy,antiviral drugs,antibacterial drugs,glucocorticoids,mechanical ventilation or even extracorporeal membrane oxygenation(ECMO)may be adopted,and the treatment plan should be adjusted timely through multi-disciplinary cooperation.

关 键 词：2019冠状病毒病 严重急性呼吸综合征冠状病毒2 儿童 诊断 治疗 指南 

分 类 号：R511[医药卫生—内科学]