儿童腺病毒感染66例临床特点

目的探讨儿童腺病毒感染的临床特点,有助于进一步提高对儿童腺病毒感染的认识。方法回顾性分析2018年1月~2019年4月66例确诊为腺病毒肺炎患儿的临床资料,分析其临床特点、并发症、影像学及治疗过程。结果所有患儿均有发热,热程平均(8.8±5.4)d,44例出现高热(66.7%),所有患儿均有咳嗽,36例出现喘息(54.5%)。易出现并发症,易合并其他病原体感染。胸CT多表现为单侧肺或者双侧肺斑片状高密度影。纤维支气管镜下可见病变部位支气管黏膜肿胀充血,管腔内可见分泌物,病变部位与影像学的改变一致。4例患儿吸出支气管塑形样物。经抗感染及对症治疗,除1例自动出院及2例死亡外,其他均好转出院。结论儿童腺病毒肺炎以高热多见,热程长,临床表现多样,患儿可出现肺外多系统及脏器受累的表现,治疗上予对症支持治疗,必要时可行纤维支气管镜检查及灌洗治疗。

Clinical analysis of 66 children with adenovirus infection

Objective To explore the clinical characteristics of children's adenovirus infection is helpful to further improve the understanding of children's adenovirus infection.Methods The clinical data of 66 children with adenovirus pneumonia diagnosed from January 2018 to April 2019 were retrospectively analyzed.The clinical characteristics,complications,imaging and treatment were analyzed.Results All children had fever,the average duration of fever was(8.8+5.4)days,44 cases had high fever(66.7%),all children had cough,36 cases had wheeze(54.5%).It is easy to cause complications and other pathogenic infections.Thoracic CT showed patchy high density images of unilateral or bilateral lungs.Bronchial mucosa swelling and hyperemia were observed under fiberoptic bronchoscope,and secretions were seen in the lumen.The lesion location was consistent with the imaging changes.Bronchial plastics were aspirated in 4 children.After anti-infection and symptomatic treatment,all patients were discharged from hospital except 1 case of automatic discharge and 2 cases of death.Conclusion Adenovirus pneumonia in children is characterized by high fever,long course of fever and various clinical manifestations.The children may have manifestations of extra-pulmonary multiple system and organ involvement.Symptomatic supportive treatment should be given in the treatment.Fiberoptic bronchoscopy and lavage treatment can be performed if necessary.