儿童重症呼吸道合胞病毒感染  

Severe respiratory syncytial virus infection in children

作　　者：刘霜[1] 曲东[1] Liu Shuang;Qu Dong(Department of Critical Care Medicine,Children′s Hospital of the Capital Institute of Pediatric,Beijing 100020,China)

机构地区：[1]首都儿科研究所附属儿童医院重症医学科,北京100020

出　　处：《中国小儿急救医学》2024年第9期652-657,共6页Chinese Pediatric Emergency Medicine

基　　金：首都儿科研究所临床基础结合专项(JHYJ-2025-04)。

摘　　要：呼吸道合胞病毒(RSV)是造成婴幼儿病毒性呼吸道感染住院的首要因素,成为全球主要的医疗保健负担。重症主要风险因素包括年龄<3个月、慢性心肺疾病和免疫抑制,通常与较差的结局相一致。虽然大多数RSV住院患儿为健康足月婴幼儿,但有基础疾病的儿童需要重症监护的比例较高。RSV感染的急性下呼吸道感染临床表型可分为细支气管炎或肺炎、大的肺内分流和急性呼吸窘迫综合征(ARDS)。可以采用细支气管炎临床评估量表来判断RSV细支气管炎患儿的严重程度。重症RSV感染的治疗主要为支持性措施。无创机械通气和高流量氧疗为首选,严重呼吸窘迫和ARDS需要有创呼吸支持和(或)体外膜肺氧合治疗。正在开发的RSV新疫苗及Nirsevimab被动免疫有望降低严重RSV疾病的医疗负担。Respiratory syncytial virus(RSV)is the most common reason for lower respiratory tract infections in children's hospitalization.The burden of RSV disease is widely recognized.Main risk factors for severe disease,such as extreme age(<3 months),chronic cardiopulmonary conditions,and immunosuppression,typically coincide with poorer outcomes.While most RSV hospitalizations involve healthy children,a higher proportion of hospitalized infants with underlying conditions need intensive care.Lower respiratory tract disease caused by RSV may present as bronchiolitis or pneumonitis,a large intrapulmonary shunt and acute respiratory distress syndrome(ARDS).The bronchiolitis clinical assessment scales were used to determine the severity of the children.Presently,treatment primarily consists of supportive measures.Non-invasive mechanical ventilation and high-flow oxygen therapy represented significant advancements in the management of severe RSV disease in children.Severe respiratory distress and ARDS need invasive mechanical ventilatory support and/or extracorporeal membrane oxygenation therapy.New vaccines for RSV under development and immune passive strategies involving Nirsevimab are expected to reduce the medical burden of severe RSV disease.

关 键 词：呼吸道合胞病毒 细支气管炎 急性呼吸窘迫综合征 治疗 

分 类 号：R725.6[医药卫生—儿科]