儿童社区获得性肺炎的流行特征和临床表现及病原菌调查  

Epidemiological characteristics and clinical manifestations of children with community-acquired pneumonia and distribution of pathogens

作　　者：房亚菲[1] 刘丽娟[1] 霍晨 FANG Ya-fei;LIU Li-juan;HUO Chen(Lianyungang First People's Hospital,Lianyungang,Jiangsu 222002,China)

机构地区：[1]连云港市第一人民医院儿内科,江苏连云港222002

出　　处：《中华医院感染学杂志》2020年第5期752-756,共5页Chinese Journal of Nosocomiology

摘　　要：目的调查儿童社区获得性肺炎的流行特征、临床表现与病原菌检出情况.方法选择连云港市第一人民医院2017年2月-2019年2月诊断为儿童社区获得性肺炎的586例患儿,根据小儿年龄将其分为婴儿组200例,幼儿组203例,学龄前组131例,学龄期组30例.设计一般情况调查表,询问并记录患儿一般资料、其他检查情况、听诊结果等,记录病原菌鉴定结果.结果586例儿童社区获得性肺炎患儿主要涉及年龄范围为1个月~14岁,主要集中于1个月~3岁.儿童社区获得性肺炎的危险因素调查显示:诱因不明确者占比高,为55.29%.586例儿童社区获得性肺炎患儿中有食物过敏/湿疹史者243例,占41.47%.患儿多伴咳嗽、气促症状,婴儿组发热症状相对少见,伴或不伴喘息、腹泻等症状,各年龄段患儿皮疹均少见.肺部听诊湿啰音是疾病主要体征,多伴喘鸣.心肌损害是常见合并症,轮状病毒肠炎主要发生于婴幼儿时期.586例患儿病原体阳性检出率为62.29%,共检出病原体479株,主要为病毒感染,后依次为细菌感染、非典型性病原体感染.婴儿组、幼儿组、学龄前组、学龄期组病原体检出率分别为70.00%、69.46%、38.93%、63.46%,其中学龄前组病原体检出率最低,均低于其他3组(P<0.05).结论儿童社区获得性肺炎主要集中于≤3岁婴幼儿,发病诱因多不明确,过敏体质占比较高,咳嗽、发热、气促是其主要临床表现,肺部听诊湿罗音、喘鸣音是其主要体征;病原体以病毒感染为主,各年龄段病原体分布类型不同,临床应重视各年龄段病原体检测与合理抗生素的应用.OBJECTIVE To investigate the epidemiological features, clinical manifestations and pathogens of community-acquired pneumonia(CAP) in children. METHODS A total of 586 children who were diagnosed as CAP in Lianyungang First People’s Hospital from February 2017 to February 2019 were enrolled. They were divided into 200 cases of infant group, 203 cases of young children group, 131 cases of preschool group and 30 cases of school-age group according to the age of children. The general situation questionnaire was designed to record the general data of children, examinations, auscultation results and the results of pathogen identification. RESULTS The range of age in 586 children with CAP was 1 month to 14 years old, mainly concentrated in 1 month to 3 years old. The investigation results of risk factors of CAP in children showed that the ratio of unclear predisposing factors in CAP children was high, accounting for 55.29%. Among 586 children with CAP, 243 cases had a history of food allergy/eczema, accounting for 41.47%. The CAP children were often accompanied by cough and shortness of breath. The fever symptoms in the infant group were relatively rare. They were with or without wheezing and diarrhea. Rashes were rare in all groups. Lung rale was the main sign of the disease, accompanied by wheezing. Myocardial damage was a common complication of the disease, and rotavirus enteritis mainly occurred in infants and young children. The positive detection rate of pathogen in 586 children was 62.29%, and a total of 479 strains of pathogens were detected. The main infection was viral infection, followed by bacterial infection and atypical pathogen infection. The detection rates of pathogens in infant group, young children group, preschool group and school-age group were 70.00%, 69.46%, 38.93% and 63.46%, respectively. The detection rate of pathogens in the preschool group was the lowest, which was lower than that in the other 3 groups(P<0.05). CONCLUSION CAP in children was mainly concentrated in infants and young children(

关 键 词：社区获得性肺炎 临床特征 病原菌分布 

分 类 号：R725.6[医药卫生—儿科]