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目的分析8月龄内婴儿麻疹合并支气管肺炎的临床特征及防治措施。方法回顾性分析该院2014年12月-2015年1月收治的30例8月龄内麻疹合并支气管肺炎患儿的临床资料,按照治疗方式分为对照组(n=14)与观察组(n=16),对照组接受对症治疗,观察组加用丙种球蛋白佐治。比较两组疗效,统计咳嗽、憋喘、肺部体征消失时间,退烧时间及住院时间。结果 (1)8月龄内婴儿麻疹合并支气管肺炎男性所占比例高于女性;发病月龄为2~8月,以5~7月多见,平均(7.2±2.3)月;地域分布以农村为主;有明确麻疹接触史者占50.00%;住院时间(7.3±2.4)d;喂养方式以母乳喂养为主;均可见不同程度皮疹、发热、咳嗽,并伴有黏膜斑、结膜炎、腹泻等表现;大部分可见胸片改变,实验室检查异常率高;麻疹病毒抗体检验阳性率100.00%。(2)在麻疹合并支气管肺炎患儿发病影响因素中,以月龄≥4月、冬春季节、有呼吸系统疾病史患儿发病率较高为相关危险因素。(3)观察组治疗总有效率为93.75%,明显高于对照组的64.29%(均P<0.05)。(4)观察组咳嗽消失时间、憋喘消失时间、退热时间、肺部体征消失时间及住院时间均短于对照组(均P<0.05)。结论 8月龄内麻疹合并支气管肺炎临床发病率高,以发热、皮疹、咳嗽、黏膜斑、流涕、结膜炎、呼吸困难、腹泻为主要症状,伴有白细胞、中性粒细胞增多,以冬春季节常发、呼吸道感染史、麻疹疫苗滴度降低为其发病的相关危险因素,早期接受对症处理,辅以丙种球蛋白干预,可明显改善麻疹合并支气管肺炎患儿症状,促进体征消失。
Objective To analyze the clinical features and preventive measures of infant measles with bronchopneumonia within 8 months. Methods The clinical data of 30 children with measles and bronchopneumonia within 8 months of age from December 2014 to January 2015 in our hospital were retrospectively analyzed. According to the treatment methods, they were divided into control group (n = 14) and observation group (n = 16), the control group received symptomatic treatment, the observation group plus gamma globulin treatment. The curative effect of the two groups were compared, cough, wheezing, disappearance of lung signs, fever relief time and hospitalization time. Results (1) The proportion of males with measles and bronchopneumonia within 8 months of age was higher than that of females. The onset age was from February to August and was more common in May to July, with an average of (7.2 ± 2.3) months. The geographical distribution was in rural areas Mainly with a clear history of measles exposure 50.00%; hospitalization time (7.3 ± 2.4) d; feeding mode to breastfeeding are; all to see varying degrees of rash, fever, cough, and associated with mucosal plaques, conjunctivitis, diarrhea And other performance; most visible changes in chest X-ray, laboratory abnormalities high rate; measles virus antibody test positive rate of 100.00%. (2) Among the influencing factors of children with measles complicated with bronchopneumonia, the incidence of measles complicated with bronchopneumonia was higher in children with the age of> 4 months, winter and spring and respiratory diseases as the relevant risk factors. (3) The total effective rate of the observation group was 93.75%, which was significantly higher than 64.29% of the control group (all P <0.05). (4) The disappearance time of cough, the disappearance of asthma, the time of fever relief, the disappearance of lung signs and the length of hospital stay in the observation group were shorter than those in the control group (all P <0.05). Conclusion The clinical incidence of measles complicated with bronchopneumonia in 8 months old is high, with the main symptoms of fever, rash, cough, mucosa, runny nose, conjunctivitis, dyspnea and diarrhea accompanied by leucocyte and neutrophil increase. Spring season often, history of respiratory tract infection, measles vaccine titers reduced as the risk factors associated with its onset, early symptomatic treatment, supplemented with gamma globulin intervention can significantly improve children with measles complicated with bronchial pneumonia symptoms and promote signs disappeared.