小儿甲型h1n1流感重症与危重症比较

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1、为10"--'27d，平均17．27+5．57d，重症组显著短于危重症组(P<0．05)o结论：1．相对于甲型H1N1流感重症患儿，危重症患几发病年龄较大，受损器官数目较多，更容易发生严重的低氧血症，甚至ARDS和MODS，更易出现死亡或者脑萎缩、肺纤维化等后遗症改变；2．早期的Pa02／Fi02、CK等指标、影像学检查及PRISMIII、PCIS评分有助于临床医生对甲型H1N1流感患儿病情危重程度尽早作出正确判断；3．警惕有缺铁性贫血、脑性瘫痪和先天性心脏病等基础疾病的患儿发展成为危重症；4．在选择抗生素时要考虑到重症和危重症患儿混合感染细菌谱的异同。关键

2、词：儿童；甲型H1N1流感；重症；危重症；呼吸窘迫综合症作者：柏振江指导教师：徐仑教授封其华教授ⅡCompareofclinicalcharacterbetweensevereandcriticalillchildren们tIlnovelHINlinfluenzaAbs粤呸CompareofclinicalcharacterbetweensevereandcriticalillchildrenwithnovelH1N1influenzaAbstractObjectives：Tostudydifferentclinicalcharacteristicsandr

3、iskfactorsofsevereandcriticalillchildrenwithnovelH1N1influenza，thentoguideprophylaxisandtherapy．Methods：1．GeneraldataSeventy-sixchildrenwithnovelH1N1influenzawereadmittedtoourhospitalfromOctl吐2009toDec15tll2009．andtheirclinicaldatawerecollected．Thesecasesconsistedof46malesand30fema

4、les，themean(SD)agewas3．29-土：2．90years，25cases(32．9％)weredistributedin0-．。1years，17cases(22．4％)in～3years，18cases(23．7％)in～5years，16cases(21．1％)in"-16years．Accordingto《ThethirdeditiondiagnosisandtreatmentprogramofnovelH1N1influenza))issuedbytheHealthDepartment,the76casesweredividedin

5、to2groups：severegroupandcriticalgroup．2．MethodsAllthedatacollectedbyhandwithuniformformincluded：physicaldata，vitalsigns，twokindsofscores，routinetestsofblood，urineandstool，bloodgasanalysis，biochemistry,testsofcytoimmunityandhumoralimmunityandetc，allkindsofdrugs，mechanicalventilation

6、parametersandindexofrespiratoryandcirculationifmechanicalventilationreceivedarealsoincluded．DynamicchecksofX-rayorCTwererequiredtoobservetheimagingchanges．Accordingtotheextentofthelesioninvolvementattheearlyphaseofadmission，thelesionwasclassifiedasthreegrade：mild(1～2lungfieldsinvol

7、ved)，moderate(3"、'41ungfieldsinvolved)，andsevere(5"--6lungfieldsinvolved)．Accordingtothelesionpattern，HIgastrointestinalbleedingweremoreoftenincriticalcases．3．Theproportionofcoinfectionsinseverecases(68．3％)washigherthanthatincriticalcases(37．5％)(P

8、asfoundcommoninseverecases