临床荟萃 ›› 2024, Vol. 39 ›› Issue (2): 140-143.doi: 10.3969/j.issn.1004-583X.2024.02.008

• 论著 • 上一篇    下一篇

新冠疫情前后重症肺炎合并急性呼吸衰竭患儿的临床特点与病原学分析

黄赛虎1(), 龙中洁2, 吴水燕1, 柏振江1   

  1. 1.苏州大学附属儿童医院 重症医学科,江苏 苏州 215000
    2.松桃苗族自治县人民医院,贵州 铜仁 554100
  • 收稿日期:2023-10-06 出版日期:2024-02-20 发布日期:2024-04-18
  • 通讯作者: 黄赛虎 E-mail:hsh333246@126.com

Clinical characteristics and etiological analysis of severe pneumonia complicated with acute respiratory failure in children before and after COVID-19

Huang Saihu1(), Long Zhongjie2, Wu Shuiyan1, Bai Zhenjiang1   

  1. 1. Department of Critical Care Medicine, Children’s Hospital of Soochow University, Suzhou 215000, China
    2. People’s Hospital of Songtao Miao Autonomous County, Tongren 554100, China
  • Received:2023-10-06 Online:2024-02-20 Published:2024-04-18
  • Contact: Huang Saihu E-mail:hsh333246@126.com

摘要:

目的 探讨苏州地区新冠疫情前后急性重症肺炎合并呼吸衰竭(sever pneumonia complicated with acute respiratory failure, SP-ARF)患儿的临床特点与病原学分析结果。方法 本研究回顾性分析2018年1月至2021年12月所有入住苏州大学附属儿童医院SP-ARF患儿病历资料,根据疫情发生时间分为疫情前组(2018年1月至2019年12月)与疫情后组(2020年1月至2021年12月)2组,比较2组临床资料及病原学结果等。结果 疫情前组141例,疫情后组127例,疫情后组月龄较大(P<0.05),合并基础疾病比例更高(P<0.05),疫情前后每年10-12月均是SP-ARF高发时段。疫情前病原学总检出116例,阳性率为82.27%,检出前4位依次为革兰阴性菌(36.88%)、革兰阳性菌(26.95%)、病毒(26.95%),肺炎支原体(9.22%);疫情后病原学总检出109例,阳性率为85.83%,检出前4位依次革兰阴性菌(37.80%)、病毒(28.35%)、革兰阳性菌(22.83%),肺炎支原体(9.45%)。结论 疫情后无基础疾病的儿童进展为SP-ARF发生比例减少,无论疫情前后,每年10-12月均是SP-ARF高发时段,且两组患儿的病原体均以细菌为主,革兰阴性菌占比最高。

关键词: 肺炎, 呼吸功能不全, 新型冠状病毒感染

Abstract:

Objective To investigate the clinical characteristics and etiological analysis of severe pneumonia complicated with acute respiratory failure (SP-ARF) in children before and after the coronavirus disease 2019 (COVID-19) outbreak in Suzhou. Methods This study retrospectively analyzed the medical records of all SP-ARF children admitted to the Children’s Hospital of Soochow University from January 2018 to December 2021, and they were divided into pre-epidemic group (January 2018 to December 2019) and post-epidemic group (January 2020 to December 2021) according to the outbreak time. The clinical data and etiological results of the two groups were analyzed. Results There were 141 cases in the pre-epidemic group and 127 cases in the post-epidemic group. The month-age of children with SP-ARF in the post-epidemic group were older than those of pre-epidemic group (P<0.05), and with a higher proportion of combined underlying diseases (P<0.05). The peak period of SP-ARF was from October to December every year regardless of before or after the epidemic. The positive rate of etiological examination in pre-epidemic group was 82.27%(116/141). The top 4 bacteria were in order of Gram-negative bacteria (36.88%), Gram-positive bacteria (26.95%), viruses (26.95%), and mycoplasma pneumoniae (9.22%). The positive rate of etiological examination in posr-epidemic group was 85.83% (109/127), and the top 4 bacteria were in order of Gram-negative bacteria (37.80%), virus (28.35%), Gram-positive bacteria (22.83%), and Mycoplasma pneumoniae (9.45%). Conclusion After the epidemic, the proportion of children without underlying diseases developing SP-ARF decreased, SP-ARF occurred frequently from October to December every year regardless of before or after the epidemic. The pathogens of the two groups were mainly bacteria, with highest proportion of Gram-negative bacteria.

Key words: pneumonia, respiratory insufficiency, COVID-19

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