ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2019, Vol. 11 ›› Issue (6): 512-515.

• 临床研究 • 上一篇    下一篇

婴幼儿百日咳综合征患儿68例临床特点分析

  

  • 出版日期:2019-12-25 上线日期:2023-12-06

Analysis of clinical features of pertussis syndrome in infants

  • Published:2019-12-25 Online:2023-12-06

摘要： 目的探讨婴幼儿百日咳综合征的临床特点,为疾病的诊治提供依据。方法选取2017年12月至2018年12月在江西省儿童医院急诊病房住院的68例年龄≤3岁百日咳综合征患儿为研究对象,其中≤6个月32例,>6个月36例;病情程度轻症者50例,重症者18例。对各组临床资料进行比较分析。结果发病高峰为冬春季节,均以咳嗽为主诉入院。≤6月龄患儿面色潮红、咳嗽后发绀、鸡鸣样回声、重症病例、血常规白细胞计数均高于>6月龄患儿,且1周内痉挛性咳嗽消失者少于>6月龄患儿,住院时间更长,差异均有统计学意义(P<0.05)。重症患儿年龄明显小于轻症患儿,咳嗽后发绀发生率、胃食管反流发生率、混合病毒感染发生率、住院时间、血常规白细胞计数均高于轻症患儿,差异有统计学意义(P<0.05)。68例患儿住院时间为3～26 d,平均住院时间为9.02 d。给予抗感染、雾化吸入及支持治疗,36例(52.9%)患儿治愈出院;30例(44.1%)患儿临床症状改善,2例(3.0%)患儿因病情加重转PICU进一步治疗。结论百日咳综合征以婴幼儿为多见,阵发性痉挛性咳嗽是其共有的表现,而≤6个月百日咳综合征患儿临床表现更为典型;对于合并胃食管反流、有混合感染、白细胞计数明显升高需警惕发展为重症的可能。

关键词:

百日咳综合征, 临床特点, 婴幼儿

Abstract:

ObjectiveTo investigate the clinical features of pertussis syndrome in infants, and to provide evidence for the diagnosis and treatment of the disease. MethodsA total of 68 infants with pertussis syndrome aged under 3 years old treated in the Emergency Ward of Jiangxi Children's Hospital from December 2017 to December 2018 were chosen as the research subjects. Among them, 32 cases were ≤6 months, 36 cases were >6 months; 50 cases were mild cases, and 18 cases were severe cases. Clinical data were compared among the groups. ResultsThe peak incidence was in winter and spring. All patients were admitted to hospital with cough as the chief complaint. In the group of infants under 6 months old, the number of cases of facial flushing, cyanosis after cough, chicken-like echo and severe cases, and white blood cell count in routine blood testing were higher than those in the group of infants over 6 months old; the cases whose spastic cough disappeared in one week were fewer than the group of infants over 6 months, and the hospitalization time was longer; the differences were statistically significant（P<0.05). The severe group was significantly younger than the mild group (P<0.01). The incidence of cyanosis after cough, the incidence of gastroesophageal reflux, the incidence of mixed virus infection, the hospitalization time and the routine white blood cell count in the severe group were significantly higher than those in the mild group; the differences were statistically significant (P<0.05). The hospitalization time of 68 children was 3 to 26 days, and the average hospitalization time was 9.02 days. After anti-infective, aerosol inhalation and supportive treatment, 36 patients (52.9%) were cured and discharged from hospitals, 30 patients (44.1%) had clinical symptoms improved, and 2 patients (2.9%) were further treated in PICU due to exacerbation.ConclusionPertussis syndrome is more common in infants and young children, paroxysmal spastic cough is a common manifestation, and the clinical manifestations in children under 6 months who have pertussis syndrome are more typical; the cases combined with gastroesophageal reflux, mixed infection, and marked increase in white blood cell count need to be alert to the possibility of developing into serious cases.

Key words:

Pertussis syndrome, Clinical features, Infants