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目的探讨新生儿甲型流感的临床特点、诊断及治疗。方法选择2009年11月至2010年2月本院新生儿内科病房收治的甲型流感患儿进行回顾性分析。结果甲型流感患儿中新型甲型H1N1流感2例,患病前有感冒患者接触史4例,症状表现为发热、吐沫、咳嗽、呛奶、反应弱、纳差、腹泻。甲型流感病毒通用M基因阳性6例;猪H1N1流感病毒通用NP基因阳性2例;白细胞总数升高3例;分类以中性粒细胞为主4例;C反应蛋白升高3例;心肌酶升高4例;肝酶升高1例;胸部X线片示肺炎3例;心电图T波低平2例,ST段上移1例;血培养均阴性;脑脊液常规、生化均正常。6例患儿均未使用奥司他韦等抗病毒药物,以抗生素、中药以及保肝、营养心肌等对症支持治疗,预后良好。结论新生儿甲型流感临床表现缺乏特异性,患儿可出现肺炎、心肌损害、肝功损害等并发症,但病程多具有自限性,预后较好,是否需应用奥司他韦等抗病毒药物有待探讨。
Objective To investigate the clinical features, diagnosis and treatment of neonatal influenza A (A). Methods A retrospective analysis of children with influenza A admitted to neonatal medical ward from November 2009 to February 2010 was conducted. Results There were 2 new cases of influenza A (H1N1) in children with influenza A and 4 cases of cold contact before the illness. The symptoms were fever, spittle, cough, choking, weak reaction, anorexia and diarrhea. 6 cases were positive for M gene of Influenza A virus, 2 cases were general NP gene of swine H1N1 influenza virus, 3 cases were increased in white blood cells, 4 cases were classified as neutrophils, 3 cases were elevated C-reactive protein, Elevated in 4 cases; increased liver enzymes in 1 case; chest X-ray showed pneumonia in 3 cases; electrocardiogram T wave low in 2 cases, ST-segment up 1 case; blood culture were negative; cerebrospinal fluid routine, biochemical were normal. 6 cases of children did not use oseltamivir and other antiviral drugs, antibiotics, traditional Chinese medicine and hepatoprotective, nourishing the heart and other symptomatic and supportive treatment, the prognosis is good. Conclusion The clinical manifestations of neonatal influenza A lack of specificity, children may have pneumonia, myocardial damage, liver damage and other complications, but the duration of more self-limiting, the prognosis is good, the need to apply oseltamivir and other antiviral Drugs to be explored.