西南军医
西南軍醫
서남군의
JOURNAL OF MILITARY SURGEON IN SOUTHWEST CHINA
2014年
5期
501-503
,共3页
刘华君%许红波%王太森%刘文彬%汤雪晴%吕洁
劉華君%許紅波%王太森%劉文彬%湯雪晴%呂潔
류화군%허홍파%왕태삼%류문빈%탕설청%려길
新生儿%社区感染性肺炎%病原学%X线胸片
新生兒%社區感染性肺炎%病原學%X線胸片
신생인%사구감염성폐염%병원학%X선흉편
neonate%community-acquired pneumonia (CAP)%etiology%chest X-ray
目的:分析新生儿社区感染性肺炎的临床特点。方法对213例新生儿社区感染性肺炎的临床资料进行回顾性分析。结果(1)临床表现和体征:气促173例,发绀128例,咳嗽137例,口吐白沫121例,发热86例,三凹征97例,肺部呼吸音粗87例,肺部闻及干湿啰音92例,黄疸95例。(2)病原学:痰培养阳性82例,其中革兰阴性杆菌64例。(3)感染指标:白细胞(WBC)升高108例,C反应蛋白升高40例,降钙素原升高87例。(4) X线胸片:双肺纹理增多、模糊,肺门影模糊137例,小点片状影31例。(5)心脏彩超检查有先心病116例。结论新生儿社区感染性肺炎的临床表现不典型,痰培养阳性率较低,感染指标特异性不高,X线胸片大多有改变,合并先心病的患儿患社区感染性肺炎的比例明显较高,因此诊断和治疗时需进行综合考虑。
目的:分析新生兒社區感染性肺炎的臨床特點。方法對213例新生兒社區感染性肺炎的臨床資料進行迴顧性分析。結果(1)臨床錶現和體徵:氣促173例,髮紺128例,咳嗽137例,口吐白沫121例,髮熱86例,三凹徵97例,肺部呼吸音粗87例,肺部聞及榦濕啰音92例,黃疸95例。(2)病原學:痰培養暘性82例,其中革蘭陰性桿菌64例。(3)感染指標:白細胞(WBC)升高108例,C反應蛋白升高40例,降鈣素原升高87例。(4) X線胸片:雙肺紋理增多、模糊,肺門影模糊137例,小點片狀影31例。(5)心髒綵超檢查有先心病116例。結論新生兒社區感染性肺炎的臨床錶現不典型,痰培養暘性率較低,感染指標特異性不高,X線胸片大多有改變,閤併先心病的患兒患社區感染性肺炎的比例明顯較高,因此診斷和治療時需進行綜閤攷慮。
목적:분석신생인사구감염성폐염적림상특점。방법대213례신생인사구감염성폐염적림상자료진행회고성분석。결과(1)림상표현화체정:기촉173례,발감128례,해수137례,구토백말121례,발열86례,삼요정97례,폐부호흡음조87례,폐부문급간습라음92례,황달95례。(2)병원학:담배양양성82례,기중혁란음성간균64례。(3)감염지표:백세포(WBC)승고108례,C반응단백승고40례,강개소원승고87례。(4) X선흉편:쌍폐문리증다、모호,폐문영모호137례,소점편상영31례。(5)심장채초검사유선심병116례。결론신생인사구감염성폐염적림상표현불전형,담배양양성솔교저,감염지표특이성불고,X선흉편대다유개변,합병선심병적환인환사구감염성폐염적비례명현교고,인차진단화치료시수진행종합고필。
Objective To analyze the clinical features of neonatal community-acquired pneumonia (CAP). Methods A retrospective analysis was made to the clinical data of 213 neonates with CAP. Results Clinical manifestations and physical signs: dyspnea was found in 173 ccases, cyanosis in 128 cases, cough in 137 cases, buccal foam in 121 cases, fever in 86 cases, three depression sign in 97 cases, crude breath in 87 cases, rales or rhonchi in 92 cases and jaundice in 95 cases;etiological study:out of 82 positive cases of spu-tum culture, there were 64 cases with Gram-positive bacteria;infection index:WBC increase was found in 108 cases, C-reactive pro-tein increase in 40 cases and procalcitionin ( PCT ) increase in 87 cases;chest X-ray findings:increased blur imaging of lung-marking and hilar was found in 137 cases and images of dotted flake shadows in 31 cases;cardiac color ultrasound indicated congenital heart dis-ease (CHD)) in 116 cases. Conclusions The clinical manifestations of neonatal CAP are atypical with low positive rate of sputum cul-ture, weak specificity and more changes in chest X-ray, the rate of CHD complication is obviously higher, which should be taken into consideration while making diagnosis and treatment.