儿童社区获得性肺炎124例临床诊治回顾性分析  

Retrospective analysis of clinical diagnosis and treatment of 124 cases of community-acquired pneumonia in children

作　　者：冯孝强[1] 宋建刚[1] 李元霞[1] FENG Xiaoqiang;SONG Jiangang;LI Yuanxia(Pediatrics Department,Yan'an University Affiliated Hospital,Yan'an 716000,China)

机构地区：[1]延安大学附属医院儿科,陕西延安716000

出　　处：《临床医学研究与实践》2022年第17期19-22,共4页Clinical Research and Practice

基　　金：陕西省卫生健康科研基金项目(No.2018D081);延安大学附属医院2022年度院内培育基金项目(No.2022PT-09)。

摘　　要：目的分析延安地区冬季儿童不同病理类型社区获得性肺炎的临床特点、病原学、实验室及影像学检查结果,旨在为今后本地区该病的临床诊治提供参考。方法选取延安大学附属医院儿科收治的124例社区获得性肺炎患儿,其中大叶性肺炎54例(大叶性肺炎组)、支气管肺炎70例(支气管肺炎组),对其临床表现及病原学、实验室、影像学检查结果进行统计分析。结果大叶性肺炎组的平均年龄为(68.33±32.24)个月,大于支气管肺炎组的(50.43±15.88)个月(P<0.05)。大叶性肺炎组患儿的发热、胸痛、胸部叩击浊音及并发症发生率高于支气管肺炎组,肺部固定性湿啰音发生率低于支气管肺炎组(P<0.05)。大叶性肺炎组的FeNO及MP-IgM阳性率高于支气管肺炎组(P<0.05)。结论2019年冬季延安市社区获得性肺炎儿童中,大叶性肺炎患儿的平均年龄较支气管肺炎大,大叶性肺炎的病原体按感染率从高到低依次为肺炎支原体、病毒、细菌,而支气管肺炎依次为病毒、肺炎支原体、细菌。不同年龄段的病原体亦有差别,3岁以上肺炎支原体感染较多,3岁以下病毒感染较多,细菌感染在婴幼儿中略多于年长儿。Objective To analyze the clinical characteristics,etiology,laboratory and imaging examination results of community-acquired pneumonia in children with different pathological types in winter in Yan'an area,so as to provide reference for the clinical diagnosis and treatment of the disease in this area in the future.Methods A total of 124 children with community-acquired pneumonia treated in pediatrics department of the Yan'an University Affiliated Hospital were selected,including 54 cases of lobar pneumonia(lobar pneumonia group)and 70 cases of bronchopneumonia(bronchopneumonia group).The clinical manifestations,etiology,laboratory and imaging examination results were statistically analyzed.Results The average age of the lobar pneumonia group was(68.33±32.24)months,which was significantly greater than(50.43±15.88)months of the bronchopneumonia group(P<0.05).The incidences of fever,chest pain,chest percussion dullness and complications in the lobar pneumonia group were higher than those in the bronchopneumonia group,and the incidence of fixed wet rales in lung was lower than that in the bronchopneumonia group(P<0.05).The FeNO and positive rate of MP-IgM in the lobar pneumonia group were significantly higher than those in the bronchopneumonia group(P<0.05).Conclusion In the winter of 2019,among the children with community-acquired pneumonia in Yan'an city,the average age of children with lobar pneumonia is older than that of children with bronchopneumonia.The pathogens of lobar pneumonia are Mycoplasma pneumoniae,virus and bacteria in turn according to the infection rate from high to low,which of bronchopneumonia are virus,Mycoplasma pneumoniae and bacteria in turn.Pathogens in different age groups are also different.There is more Mycoplasma pneumoniae infection over 3 years old,more virus infection under the 3 years old,and bacterial infection in infants and young children is slightly more than that in older children.

关 键 词：社区获得性肺炎 儿童 病原学 肺炎支原体 

分 类 号：R563.1[医药卫生—呼吸系统]