临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
2014年
14期
1207-1210
,共4页
新生儿%呼吸道合胞病毒%下呼吸道感染%临床特征
新生兒%呼吸道閤胞病毒%下呼吸道感染%臨床特徵
신생인%호흡도합포병독%하호흡도감염%림상특정
Neonatal infants%Respiratory synCysial virus%Lower respiratory tract infection%Clinical characteristics
目的：探讨新生儿呼吸道合胞病毒下呼吸道感染的临床特征。方法对2013年2月至2014年2月期间NICU 收治的新生儿肺炎及毛细支气管炎患儿，用直接免疫荧光法检测痰液呼吸道合胞病毒（RSV）；对证实为 RSV 感染的临床资料进行回顾性总结分析。全部病儿除具有呼吸道症状外，肺部听诊可闻中小水泡音和/或胸片有斑片状阴影。结果检测证实为 RSV 感染者共30例，男性为多，22例（73.3%）。发病日龄为9~28 d，全部为晚期新生儿。出生时孕周35~42周（39.33±1.45周），2例为早产儿。患儿均有咳嗽症状，19例肺部听诊有中小水泡音，出现发热或喘鸣音者各有5例（16.7%）；发生呼吸衰竭3例（10.0%）。血常规及 CRP 检测大部分正常。痰培养细菌阳性14例（43.3%）。胸片表现为斑片状阴影20例（66.7%），其中有大片影2例（6.7%）；肺纹理粗重、模糊10例。经综合治疗全部病人均痊愈或好转出院。肺部啰音消失的平均病程为11.10±2.20 d；平均住院时间8.53±2.35 d。结论新生儿 RSV 下呼吸道感染的临床表现不典型，以咳嗽、鼻塞、气促及肺部中小水泡音多见，喘鸣音少见。抗生素应用的益处尚需评估。
目的：探討新生兒呼吸道閤胞病毒下呼吸道感染的臨床特徵。方法對2013年2月至2014年2月期間NICU 收治的新生兒肺炎及毛細支氣管炎患兒，用直接免疫熒光法檢測痰液呼吸道閤胞病毒（RSV）；對證實為 RSV 感染的臨床資料進行迴顧性總結分析。全部病兒除具有呼吸道癥狀外，肺部聽診可聞中小水泡音和/或胸片有斑片狀陰影。結果檢測證實為 RSV 感染者共30例，男性為多，22例（73.3%）。髮病日齡為9~28 d，全部為晚期新生兒。齣生時孕週35~42週（39.33±1.45週），2例為早產兒。患兒均有咳嗽癥狀，19例肺部聽診有中小水泡音，齣現髮熱或喘鳴音者各有5例（16.7%）；髮生呼吸衰竭3例（10.0%）。血常規及 CRP 檢測大部分正常。痰培養細菌暘性14例（43.3%）。胸片錶現為斑片狀陰影20例（66.7%），其中有大片影2例（6.7%）；肺紋理粗重、模糊10例。經綜閤治療全部病人均痊愈或好轉齣院。肺部啰音消失的平均病程為11.10±2.20 d；平均住院時間8.53±2.35 d。結論新生兒 RSV 下呼吸道感染的臨床錶現不典型，以咳嗽、鼻塞、氣促及肺部中小水泡音多見，喘鳴音少見。抗生素應用的益處尚需評估。
목적：탐토신생인호흡도합포병독하호흡도감염적림상특정。방법대2013년2월지2014년2월기간NICU 수치적신생인폐염급모세지기관염환인，용직접면역형광법검측담액호흡도합포병독（RSV）；대증실위 RSV 감염적림상자료진행회고성총결분석。전부병인제구유호흡도증상외，폐부은진가문중소수포음화/혹흉편유반편상음영。결과검측증실위 RSV 감염자공30례，남성위다，22례（73.3%）。발병일령위9~28 d，전부위만기신생인。출생시잉주35~42주（39.33±1.45주），2례위조산인。환인균유해수증상，19례폐부은진유중소수포음，출현발열혹천명음자각유5례（16.7%）；발생호흡쇠갈3례（10.0%）。혈상규급 CRP 검측대부분정상。담배양세균양성14례（43.3%）。흉편표현위반편상음영20례（66.7%），기중유대편영2례（6.7%）；폐문리조중、모호10례。경종합치료전부병인균전유혹호전출원。폐부라음소실적평균병정위11.10±2.20 d；평균주원시간8.53±2.35 d。결론신생인 RSV 하호흡도감염적림상표현불전형，이해수、비새、기촉급폐부중소수포음다견，천명음소견。항생소응용적익처상수평고。
Objective To explore the clinical characteristics of RSV lower respiratory tract infection in neonatal patients. Methods All newborns diagnosed as pneumonia and bronchiolitis admitted in neonatal intensive care unit of Capital Institute of Pediatrics during February 2013 to February 2014 were included in this study. They had been detected for RSV in the way of direct immunoflurusence assay. The clinical manifes-tations,laboratory findings,complications,treatment and prognosis were retrospectively studied. Moist rales can be heard in the lung fields and /or patchy shadows can be found in chest X - ray films in all patients with respiratory symptoms. Results Thirty specimens of nasopharyngeal se-cretion were screened as positive for RSV antigen. Boys were more likely to be infected than girls. All these cases were late - term newborn in-fants. The age of onset was 9 to 28 days. Gestational weeks were 39. 33 ± 1. 45. There were two preterm infants(2. 7% ). The chief clinical manifestations were coughing(100. 0% ),followed by small and medium rales in the lung fields in 19 cases. Only 5 cases had fever and wheez-ing. There were 3 cases complicated with respiratory failure. The white blood cell count and serum level of CRP were normal in most of these ca-ses. Chest X - ray films showed patchy shadows in 20 cases,including lobar shadows in 2 cases,and non - filtration changes in 10 cases. All of these patients recovered and discharged after comprehensive therapy. The moist rales were averagely disappeared on the day of 11. 10 ± 2. 20 in the clinical course. The average hospitalization days were 8. 53 ± 2. 35. Conclusion The clinical characteristics of RSV lower respiratory tract infec-tion in neonates are atypical and mainly manifested by coughing,stuffy nose,shortness of breath,moist rales in lung fields but rarely wheezing. Whether antibiotics are effective for RSV infection is worthy to be discussed.
