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目的 分析儿童严重急性呼吸综合征 (SARS)的临床特征。方法 北京儿童医院和地坛医院儿科病房 2 0 0 3年 4月 8日～ 5月 12日收入院的 18例有流行病学史的疑似SARS患儿 ,总结其流行病学史、临床表现和有关资料。结果 (1)流行病学史 :18例中 14例与SARS有近距离密切接触 ,4例小区有SARS患者。从密切接触到发病潜伏期 3～ 14d。 (2 )临床表现 :除 1例外均有发热和咳嗽 ,高热为主 ,1例低热。仅 2例有呼吸急促。腹泻 2例 ,头痛和乏力各 3例。 (3)胸X线片 :13例有浸润性阴影 ,9例住院后有加重趋势 ,但很快吸收好转。 (4)血清学检测 :检测的 15例中SARS病毒IgG阳性 8例 ,IgM阳性 6例。其中 4例有密切接触史而无胸X线片改变者中 3例检测了SARS病毒抗体均阴性。 (5 )治疗 :主要为对症、用抗病毒药治疗 ,多数患儿使用了丙种球蛋白 ,部分患儿使用了皮质激素治疗 ,仅 2例吸氧 ,无一例人工通气 ,无一例死亡。住院后病情迅速控制。结论 儿童SARS有其自身临床特点 ,症状、体征较成人表现为轻。 4例有密切接触史而无明显胸X线片改变的病例 ,有待可靠病原学检查证实和进一步研究。
Objective To analyze the clinical features of children with severe acute respiratory syndrome (SARS). Methods 18 children with suspected epidemic history of SARS from Beijing Children’s Hospital and Ditan Hospital from April 8 to May 12, 2003 were enrolled in this study. Their epidemiological history, clinical manifestations, data. Results (1) Epidemiological history: Among the 18 cases, 14 cases had close and close contact with SARS and 4 cases had SARS. From the close contact with the incubation period of 3 ~ 14d. (2) clinical manifestations: Except 1 exception, both have fever and cough, high fever, 1 case of fever. Only 2 cases had shortness of breath. 2 cases of diarrhea, headache and fatigue in 3 cases. (3) Chest X-ray film: There were 13 cases of invasive shadow, 9 cases increased after hospitalization trend, but soon absorbed better. (4) Serological tests: Among the 15 tested cases, 8 were positive for SARS virus IgG and 6 were IgM positive. Among them, 4 cases had close contact with history and none of the 3 cases had any negative result. (5) Treatment: The main symptomatic treatment with antiviral drugs, most children with gamma globulin, some children treated with corticosteroids, only 2 cases of oxygen, without artificial ventilation, without a death. After hospitalization the condition was quickly controlled. Conclusion Children with SARS have their own clinical features, symptoms, signs than adults showed light. 4 cases of close contact with history without obvious chest X-ray changes in the case to be confirmed by reliable etiological examination and further study.