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我院收治的220例严重急性呼吸综合征(SARS)患者中15例为18岁以下的少年儿童。其中男10例,女5例,年龄7岁1例,8～14岁4例,15～18岁10例,平均年龄15.1岁,占总住院病人数的6.8%。按SARS临床诊断标准,重新回顾15例少年儿童患者的流行病学史、临床症状、实验室检查、胸部X线、抗生素治疗反应等5个方面。认为对少年儿童患者的临床诊断,最为重要的条件是1)与SARS患者的密切接触史;2)家庭和群体聚集发病。为避免诊断的扩大化,要明确界定“疫区”和“区域”的概念。胸部X线阴影是SARS诊断依据,早期使用CT检查,可提供明确的影像诊断依据。实验室检查和对抗生素治疗反应,可提供参考。二者与典型肺炎相比,无明显差异。对少年儿童SARS患者的治疗,慎用激素,以避免激素引起的不良作用。少儿SARS患者病情较轻,减少使用贵重的其他免疫制剂,可降低SARS治疗的医药费用。少儿SARS发病率低,其原因有待于病原学的深入研究。在部分婴幼儿和少年儿童血清中,存在SARS病毒的抗体。SARS病毒和其他病毒之间存在着交叉免疫;因此,在病毒病原学的免疫检查中,需要一个金标准。
Fifty-two of the 220 patients with severe acute respiratory syndrome (SARS) admitted to our hospital were children under 18 years of age. Including 10 males and 5 females, aged 7 years in 1 case, 8 to 14 years in 4 cases, 15 to 18 years in 10 cases, the average age of 15.1 years, accounting for 6.8% of the total number of inpatients. According to SARS clinical diagnostic criteria, 15 cases of children with recurrent epidemiological history, clinical symptoms, laboratory tests, chest X-ray, antibiotic treatment response to five aspects. It is considered that the most important conditions for the clinical diagnosis of children and adolescents are 1) the close contact history with SARS patients, and 2) the incidence of familial and colony aggregation. In order to avoid the enlargement of diagnosis, the concepts of “epidemic area” and “area” should be clearly defined. Chest X-ray shadow is the basis of SARS diagnosis, early use of CT examination, can provide a clear basis for diagnostic imaging. Laboratory tests and response to antibiotic therapy can provide a reference. Compared with the typical pneumonia, no significant difference between the two. The treatment of children with SARS, caution hormone, in order to avoid the adverse effects caused by hormones. SARS patients with mild illness, reduce the use of expensive other immune agents, can reduce the cost of medical treatment of SARS. Children with low incidence of SARS, the reason to be etiological in-depth study. In some infants and children sera, there is SARS virus antibodies. There is a cross-immunity between the SARS virus and other viruses; therefore, a gold standard is required for immunological screening of viral etiologies.