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目的探讨分析安吉地区性儿童大叶性肺炎的病原学变迁以及患儿预后因素。方法回顾性分析2013年8月-2014年11月医院收治的儿童大叶性肺炎62例患儿资料,分析其病原学特征以及患儿预后相关因素,首先对各因素采取单因素分析,对具有统计学意义的各因素进行Logistic多因素回归分析。结果 62例大叶性肺炎患儿中,病原学检测48例呈阳性,阳性率为77.42%,在48例病原学检测阳性患儿中,其中以肺炎支原体分布最多,占43.75%。其次为柯萨奇病毒,占10.42%;将62例患儿分为有效组39例,无效组23例,经单因素分析比较,两组患儿在是否机械通气、住院时间、白细胞水平、中性粒细胞比值、C反应蛋白以及Pa O2六个因素上,差异具有统计学意义(P<0.05);非条件Logistic多因素分析结果显示,胸腔积液、C反应蛋白、住院时间以及机械通气四个因素因素进入回归模型(P<0.05),为影响大叶性肺炎患儿预后的独立危险因素。结论安吉地区儿童大叶性肺炎病原学以肺炎支原体感染为主,胸腔积液、C反应蛋白水平、住院时间以及机械通气是预测患儿预后的重要因素。
Objective To investigate the etiological changes of children with lobar pneumonia in Anji region and the prognosis of children. Methods A retrospective analysis was performed on 62 pediatric patients with lobar pneumonia admitted from August 2013 to November 2014 in our hospital. The etiological characteristics and prognosis-related factors were analyzed. A univariate analysis of each factor was carried out. Statistical significance of the various factors Logistic multivariate regression analysis. Results Among the 62 children with lobar pneumonia, 48 cases were positive for pathogen detection, the positive rate was 77.42%. Of the 48 children with positive pathogenic test, the majority was Mycoplasma pneumoniae, accounting for 43.75%. Followed by Coxsackie virus, accounting for 10.42%; 62 cases were divided into effective group 39 cases, ineffective group 23 cases, by univariate analysis, the two groups of children in whether the mechanical ventilation, hospital stay, leukocyte levels, (P <0.05). The results of non-conditional Logistic multivariate analysis showed that pleural effusion, C-reactive protein, length of hospital stay, and mechanical ventilation IV Factors into regression model (P <0.05), an independent risk factor for the prognosis of children with lobar pneumonia. Conclusions Mycoplasma pneumoniae is the most common aetiology of children with MPA in Anji region. Pleural effusion, C-reactive protein level, hospital stay and mechanical ventilation are important predictors of prognosis in children.