63例儿童重症水痘临床分析  

Clinical analysis of 63 cases of severe varicella in children

作　　者：周洁雯 林菁 马丙南 ZHOU Jiewen;LIN Jing;MA Bingnan(Department of Pediatrics,Guangzhou Eighth People′s Hospital,Guangzhou Medical University,Guangzhou 510080,China)

机构地区：[1]广州医科大学附属市八医院儿科,广东广州510080

出　　处：《中国现代医生》2022年第18期57-60,共4页China Modern Doctor

摘　　要：目的分析儿童重症水痘的临床特点、治疗、预后。方法对广州医科大学附属市八医院2015年1月~2020年12月收治的63例儿童重症水痘进行回顾性分析。结果本研究中28例(44.44%)患儿有慢性基础病,免疫力低下。39例(61.90%)患儿发病时及发病前曾有糖皮质激素或免疫抑制剂使用史,与普通水痘患儿比较,差异有统计学意义(P<0.05);45例(71.43%)表现为密集型疱疹;并发皮肤感染42例(66.67%),与普通水痘患儿比较,差异有统计学意义(P<0.05)。63例(100.00%)患儿均给予阿昔洛韦及丙种球蛋白治疗;治愈59例(93.65%),1例(1.59%)死亡,3例(4.76%)并发深部脓肿、蜂窝织炎等需转相关科室进一步随访治疗。。结论慢性基础病(尤其是自身免疫性疾病)、长期使用免疫抑制剂或糖皮质激素是儿童重症水痘的高危因素,密集型疱疹是常见的临床表现,出血性疱疹多预后不良。阿昔洛韦及丙种球蛋白是治疗重症水痘的首要选择,及时积极有效治疗可改善重症水痘患儿的预后。Objective To analyze the clinical characteristics,treatment,and prognosis of severe varicella in children.Methods Sixty-three children with severe varicella admitted to uangzhou Eighth People′s Hospital,Guangzhou Medical University from January 2015 to December 2020 were retrospectively analyzed.Results In this study,28 patients(44.44%)had chronic underlying diseases and low immunity.Thirty-nine patients(61.90%)had a history of glucocorticoid or immunosuppressant use at and before the onset of the disease,which was significantly different from that of children with common varicella(P<0.05).Forty-five patients(71.43%)showed intensive herpes,and 42 patients(66.67%)had concurrent skin infections,which was significantly different from that of children with common varicella(P<0.05).All 63(100.00%)children were treated with aciclovir and gamma globulin.59(93.65%)were cured,and 1(1.59%)died 3 cases(4.76%)complicated with deep abscess and cellulitis needed to be transferred to relevant departments for further follow-up treatment.Conclusion Chronic underlying diseases(especially autoimmune diseases)and long-term use of immunosuppressive agents or glucocorticoids are the high-risk factors of severe varicella in children.Intensive herpes is a common clinical manifestation,and hemorrhagic herpes has a poor prognosis.Aciclovir and gamma globulin are the primary options for treating severe varicella,and timely active and effective treatment can improve the prognosis of children with severe varicella.

关 键 词：重症 水痘 儿童 预后 

分 类 号：R725.1[医药卫生—儿科]