儿童新型冠状病毒感染流行病学与临床特点分析——对儿童疑似病例诊断标准的思考  

Epidemiological and clinical characteristics of novel coronavirus infection in children:Thoughts on the diagnostic criteria of suspected cases

作　　者：姜建渝[1] 段铃 熊道学[1] 冯琰[1] 刘祥军 余洁[1] 彭哲[1] 郎春辉 Jiang Jianyu;Duan Ling;Xiong Daoxue;Feng Yan;Liu Xiangjun;Yu Jie;Peng Zhe;Lang Chunhui(Three Gorges Hospital Affiliated to Chongqing University,Chongqing Three Gorges Central Hospital,Chongqing 404000,China)

机构地区：[1]重庆三峡中心医院,重庆大学附属三峡医院,404000

出　　处：《中国小儿急救医学》2020年第6期407-410,共4页Chinese Pediatric Emergency Medicine

摘　　要：目的通过分析儿童新型冠状病毒感染确诊病例的流行病学和临床表现特点,改进和完善疑似病例诊断标准。方法回顾分析2020年2月3日至2020年2月15日重庆三峡中心医院收治的6例儿童新型冠状病毒感染确诊病例的流行病学和临床表现,比对国家卫生健康委员会发布的《新型冠状病毒肺炎诊疗方案(试行第六版)》(简称方案)疑似病例诊断标准,总结在临床工作中应用该标准遇到的问题,并尝试提出改进建议。结果确诊6例患儿中,男5例,女1例;来自湖北3例,万州本地3例;家庭聚集性发病6例;就诊性质:疑似病例收入3例,社区或门诊筛查3例。有发热和(或)呼吸道症状3例,其中1例伴腹泻症状;所有患儿血常规及淋巴细胞计数均在正常范围;胸部CT影像学除病例1、5部分符合新型冠状病毒肺炎典型征象外,其余3例患儿影像学有异常但不具备新型冠状病毒肺炎特征,1例正常。比对结果:只有病例1完全符合方案中疑似病例的诊断标准,其余病例不符合疑似病例诊断标准。结论为提高儿童疑似病例诊断准确性,建议完善和细化方案中疑似病例的诊断标准,以提高可操作性,避免漏诊。Objective To improve the diagnostic criteria of suspected cases through investigating the epidemiological and clinical manifestations of confirmed cases of novel coronavirus infection in children.Methods We retrospectively analyzed the epidemiological and clinical manifestations of six children with novel coronavirus infection diagnosed in Chongqing Three Gorges Central Hospital from February 3,2020 to February 15,2020.Compared with the diagnostic criteria of suspected cases,we summarized the problems encountering in the application of this standard in clinic and try to put forward suggestions for improvement.Results Among the six confirmed cases:five males and one female;three from Hubei Province and three from Wanzhou;six cases of clustered onset of the family.Visiting nature:six cases of suspected case,six cases from community or outpatient screening.Three fever cases with/without respiratory symptoms,one of which had diarrhea;all children′s blood routine and lymphocyte counts were within the normal range;chest CT imagings of No.1 and No.5 case showed typical novel coronavirus pneumonia signs,and the other three patients had abnormalities without the characteristics of novel coronavirus pneumonia,and one case was normal.Comparison results:Only No.1 case fully met the diagnostic criteria,and the remaining cases did not meet the diagnostic criteria for early suspected cases.Conclusion In order to improve the accuracy and practicality of the diagnosis of suspected cases in children,it is recommended to refine and standardize the diagnostic criteria for some suspected cases.

关 键 词：新型冠状病毒 疑似病例诊断标准 儿童 

分 类 号：R725.6[医药卫生—儿科]