11例儿童甲型H1N1流感重症病例的临床分析.doc

11例儿童甲型H1N1流感重症病例的临床分析
(作者:___________单位: ___________邮编: ___________)
【摘要】目的:描述甲型H1N1重症流感患儿的临床症状特点。方法:对我院2009年11月~2010年1月共收治11例甲型H1N1重症流感患儿,进行回顾性研究,了解临床特征及为临床诊治提供一定的经验。结果:11例患儿中,男性8例,女性3例,年龄分布从2岁1月到8岁5月,起病症状均为咳嗽、发热、咳痰,所有病例均有胸片肺部感染病变,采取特异性治疗后均痊愈出院。结论:儿童甲型H1N1流感重症病例起病年龄及症状不典型,可能合并细菌感染,予抗病毒药物治疗等综合治疗,可取得较好疗效。
【关键词】甲型H1N1流感病毒;重症肺炎;脓毒症

【Abstract】Objective: To describe the clinical features of children severe pneumonia of influenza A (H1N1) infection. Methods:The epidemiological information and clinical characteristics of 11 children severe pneumonia of influenza A (H1N1) infection admitted in Zhongshan City People’s Hospital from November 1st,2009 to January 1st,1010 were reviewed by descriptive epidemiology. Results:There were 8 male and 3 female cases from 2 years,1 months to 8 years,5 months in age. The main symptoms were fever and cough with sputum. Abnormal appearance of chest X-ray included increased bronchovascular shadows, pneumonia, with or without pleural effusion. All of those cases were cured after specific therapy. Conclusions:It is easy to misdiagnose Children severe pneumonia of influenza A (H1N1) infection as there is no general first symptoms and age. Amalgamative bacterium is probably affected on the foundation with severe pneumonia of influenza A (H1N1) infection. Symptoms in the majority of patients disappeared after specific treatment.
【Key words】Swine-origin influenza A(H1N1) virus, Severe pneumonia,Sepsis
甲型H1N1流感又称人感染猪流感,于2009年3月首先在墨西哥暴发疫情,并迅速在全球范围内蔓延[1]。2009年6月11日,世界卫生组织(WHO)宣布将甲型H1N1流感大流行警告级别提升为6级,全球进入该流感大流行阶段。通过输入性病例,我国内地于2009年5月发现首例甲型H1N1流感患者,并随着疫情的进展,开始出现重症和死亡病例。截至2010年3月17日,我国内地31个省份共报告确诊病例127427例,其中累计报告重症及危重症病例8320例,死亡病例796例。儿童因为免疫力较差,更是甲型H1N1流感的易感人群,发生重症及危重症的比例较高,本次研究通过对2009年11月-2010年1月间中山市人民医院儿科病房收治的11例的诊疗过程进行回顾性分析,评价现有治疗方案的效果,为今后重症患儿的诊治总结临床经验。
1 对象与方法
对象本次研究对象为2009年11月-2010年1月间中山市人民医院儿科收治的11例甲型H1N1重症流感患儿。所以病例均符合卫生部《甲型H1N1流感诊疗方案(2009年第三版)》重症病例的诊断标准,并通过中山市市疾病预防控制中心采用RT-PCR检测咽拭子进行病原学检测,证实为确诊病例,其中4例患者符合危重症患者诊断标准。