191例儿童麻疹合并重症肺炎的流行特征及临床分析  

Epidemiological Characteristics and Clinical Analysis of 191 Cases of Childhood Measles Complicated with Severe Pneumonia

作　　者：孙玲[1] 崔晓薇[1] 孙一硕 周晓强[1] 温婵[1] SUN Ling;CUI Xiaowei;SUN Yishuo(Hebei Children's Hospital, Hebei Shijiazhuang 050031, China)

机构地区：[1]河北省儿童医院医务处,河北石家庄050031

出　　处：《河北医学》2021年第6期1004-1008,共5页Hebei Medicine

基　　金：河北省医学科学研究重点课题计划,(编号:20150561)。

摘　　要：目的:分析麻疹合并重症肺炎患儿的流行病学和临床特征、治疗措施及疾病预后,为麻疹防控,降低重症麻疹死亡率提供依据。方法:以2011年至2019年河北省儿童医院住院病房收治的191例麻疹合并重症肺炎患儿为研究对象,对患儿临床资料进行回顾性研究,采用描述流行病学方法进行流行特征分析,同时分析患儿临床特征、治疗及预后情况。结果:191例患儿男女比例为1.93:1,发病时间集中在1~6月份,年龄以1.5岁以下为主,占90.06%,地区分布以周边地市农村为主,占88.48%;69例(36.12%)有既往病史,所有患儿均有发热、皮疹、咳嗽、气促、三凹征等症状,合并症以喉炎最多见为129例(67.54%),白细胞、CRP、心肌酶、肝功能、血糖、影像学检查均有不同程度的异常,痰培养以大肠埃希杆菌为主;经综合评估,针对性治疗,治愈出院107例(56.02%),好转出院74例(38.74%),死亡和放弃治疗后死亡10例。结论:2011年至2019年麻疹合并重症肺炎发病整体出现较大波动,2014年为发病高峰,患儿呼吸、消化、心血管系统均可受累,死亡原因分别为呼吸衰竭、ARDS、MODS,应加强适龄儿童的含麻疹成分疫苗(MCV)接种覆盖率和及时接种率,对重症患儿应根据临床表现及时进行综合性治疗,降低病死率,改善患儿预后。Objective:To analyze the epidemiological and clinical characteristics,treatment measures and prognosis of children with measles complicated with severe pneumonia,so as to provide evidence for measles prevention and control and reduce the mortality of severe measles.Methods:From 2011 to 2019,191 children with measles and severe pneumonia admitted to the inpatient ward of Hebei Children's Hospital were made the research object.The clinical data of the children were retrospectively studied,and the epidemiological characteristics were analyzed by descriptive epidemiology.At the same time,the clinical features,treatment and prognosis of children were also analyzed.Results:The male to female ratio of 191 cases was 1.93:1.The onset time was from January through June,and the age was mainly under 1.5,accounting for 90.06%.The regional distribution was mainly in the surrounding cities and rural areas,accounting for 88.48%;69 cases(36.12%)have a previous medical history,all children have symptoms such as fever,rash,cough,shortness of breath,and three concave signs.The most common complication is laryngitis in 129 cases(67.54%),white blood cells,CRP,myocardial enzymes,liver function,blood sugar,and imaging examinations all had different degrees of abnormality.The sputum culture was mainly Escherichia coli;after comprehensive assessment and targeted treatment,107 cases(56.02%)were cured and discharged,and 74 cases(38.74%)were improved and discharged.10 cases died or died after giving up treatment.Conclusion:The overall incidence of measles complicated with severe pneumonia fluctuated significantly from 2011 to 2019,and 2014 was the peak of the incidence.The respiratory,digestive,and cardiovascular systems of the children could be affected.The causes of death were respiratory failure,ARDS,and MODS.The coverage rate and timely vaccination rate of children with measles component vaccine(MCV)should be treated in a timely manner based on clinical manifestations of severely ill children to reduce the mortality rate and improve the

关 键 词：麻疹 重症肺炎 流行病学 临床特征 

分 类 号：R72[医药卫生—儿科]