儿童7型腺病毒肺炎20例临床特征分析  

Clinical features of type 7 adenovirus pneumonia:a clinical analysis on 20 children

作　　者：黄晶晶[1] 袁林[1] 卓志强[1] 李明珍 Huang Jingjing;Yuan Lin;Zhuo Zhiqiang;Li Mingzhen(Third Ward,Xiamen Children’s Hospital,Children’s Hospital of Fudan University Xiamen Branch,Xiamen 361006,China)

机构地区：[1]厦门市儿童医院,复旦大学附属儿科医院厦门分院三病区,361006

出　　处：《中国实用医刊》2020年第7期18-21,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨7型腺病毒肺炎患儿的临床特征。方法回顾性分析2019年1月至2019年9月厦门市儿童医院收治的20例7型腺病毒肺炎患儿的临床资料,对患儿的临床表现、实验室检查、肺部影像学资料、纤维支气管镜镜下表现、治疗方案及疗效等进行分析,并随访观察患儿预后情况。结果20例7型腺病毒肺炎患儿均伴有发热、咳嗽,易出现呼吸困难;易引发肝功能异常、心肌损伤等合并症。20例患儿均有不同程度的乳酸脱氢酶(LDH)升高,重症患儿常合并降钙素原(PCT)升高。易混合其他病原体感染,其中以肺炎支原体感染居多,其次是流感嗜血杆菌、肺炎链球菌、烟曲霉菌。胸部影像学检查可见肺实变不张,以左下肺、右下肺为主,合并患侧少量胸腔积液。部分患儿后期遗留支气管扩张或闭塞性细支气管炎;经纤维支气管镜检查主要表现为气道黏膜充血、水肿,部分出现黏液栓甚至塑型支气管炎形成。所有患儿经综合治疗后均病情好转出院。结论7型腺病毒肺炎发病急,病情重,合并症多,病程长,缺乏特异性治疗,且易出现混合感染,导致病情迁延、反复,加大治疗难度,后期遗留后遗症概率高。适时行纤维支气管镜及肺泡灌洗治疗,对于疾病的诊断及治疗均有非常重要的意义。Objective To investigate the clinical features of children with type 7 adenovirus pneumonia.Methods The clinical data of 20 children with type 7 adenovirus pneumonia admitted to Xiamen Children’s Hospital from January 2019 to September 2019 were retrospectively analyzed.Clinical manifestations,laboratory tests results,pulmonary imaging data,bronchoscopy performance,treatment protocol and treatment efficacy of the selected children were analyzed.And the prognoses of the children were followed up.Results Twenty children with type 7 adenovirus pneumonia were complicated by fever and cough,and were prone to have dyspnea and develop complications such as abnormal liver function and myocardial injury in them.All of the 20 children had elevated lactate dehydrogenase(LDH)to varying degrees,and severe children often had elevated procalcitonin(PCT).Children with type 7 adenovirus pneumonia were prone to be infected by other pathogen,most of which were infected by Mycoplasma pneumoniae infections,followed by Haemophilus influenzae,Streptococcus pneumoniae,Aspergillus fumigatus,in sequence.Chest radiographic examination showed atelectasis,mainly in the lower left and right lungs,with a small amount of pleural effusion in the affected side.Some children had bronchiectasis or occlusive bronchiolitis at the later stage;fiberoptic bronchoscopy mainly manifested airway mucosal congestion and edema,and some of them had mucus plugs or even bronchitis.All children recovered and were discharged after comprehensive treatment.Conclusions Type 7 adenoviral pneumonia has an acute onset,severe illness,multiple comorbidities,long course of disease.Moreover,this disease lacks of specific treatment,and is prone to be complicated by mixed infection,resulting in prolonged and repetitive conditions,increasing the difficulty of treatment,and a high probability of sequelae in the later stages.Timely fiber bronchoscopy and alveolar lavage treatment are of great significance for the diagnosis and treatment of the disease.

关 键 词：儿童 7型腺病毒肺炎 纤维支气管镜 

分 类 号：R72[医药卫生—儿科]