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目的探讨甲型H1N1流感患儿的临床特点及治疗。方法对2009-11-04—2009-12-24桂林市人民医院收治的12例甲型H1N1流感重症患儿的临床资料进行回顾性分析。结果12例患儿均有发热,其中10例以呼吸道症状起病,如咽痛、咳嗽、咳痰等流感样症状;1例以消化系统症状(腹泻)起病;1例以神经系统症状起病;2例伴明显喘憋、呼吸困难;3例双肺闻及痰鸣音、湿啰音,2例闻及喘鸣音。12例患儿白细胞计数增高4例,降低3例;中性粒细胞比例增高4例,降低4例;淋巴细胞比例增高4例,降低2例;血小板计数降低1例,增高1例。6例丙氨酸转移酶(ALT)增高,7例天冬氨酸转移酶(AST)增高,7例乳酸脱氢酶(LDH)增高,7例肌酸激酶(CK)增高,3例肌酸激酶同工酶(CK-MB)增高。随着患儿病情好转,白细胞、肝功、心肌酶恢复正常。结论甲型H1N1流感重症患儿多以呼吸道症状发病,主要靶器官是肺,常合并细菌、支原体感染,出现各种并发症累及多脏器功能。以神经系统症状起病患儿进展迅速、病情凶险。
Objective To investigate the clinical characteristics and treatment of children with influenza A (H1N1). Methods The clinical data of 12 severe children with influenza A (H1N1) admitted to Guilin People ’s Hospital during 2009-11-04-2009-12-24 were analyzed retrospectively. Results All 12 patients had fever, of which 10 were respiratory symptoms, such as sore throat, cough, sputum and other flu-like symptoms; 1 patients with digestive system symptoms (diarrhea); 1 patients with neurological symptoms 2 patients with obvious wheezing, difficulty breathing; 3 cases of lung smear phonation, wet rales, 2 cases of wheezing and smell. 12 cases of children with increased white blood cell count in 4 cases, decreased in 3 cases; increased neutrophil count in 4 cases, 4 cases decreased; lymphocyte ratio increased in 4 cases, decreased in 2 cases; reduced platelet count in 1 case, an increase of 1 case. 6 cases of alanine aminotransferase (ALT) increased, 7 cases of aspartate aminotransferase (AST) increased in 7 cases of lactate dehydrogenase (LDH) increased in 7 cases of creatine kinase (CK) increased in 3 cases of creatine Kinase isoenzyme (CK-MB) increased. As children’s condition improved, white blood cells, liver function, myocardial enzymes returned to normal. Conclusions Severe influenza A (H1N1) influenza in children with respiratory symptoms, the main target organ is the lungs, often associated with bacteria, mycoplasma infection, a variety of complications involving multiple organ function. The onset of neurological symptoms in children with rapid progress, dangerous condition.