Department of Pediatrics, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, 33 Beiling Street, Huanggu District, Shenyang, Liaoning 110032, China.
BMC Complement Altern Med. 2013 Dec 23;13:367. doi: 10.1186/1472-6882-13-367.
Community-acquired pneumonia in children is common in China. To understand current clinical characteristics and practice, we conducted a cross-sectional study to analyze quality of care on childhood pneumonia in eight eastern cities in China.
Consecutive hospital records between January 1, 2010 and December 31, 2010 were collected from 13 traditional Chinese medicine (TCM) and western medicine (WM) hospitals in February, May, August, and November (25 cases per season, 100 cases over the year), respectively. A predesigned case report form was used to extract data from the hospital medical records.
A total of 1298 cases were collected and analyzed. Symptoms and signs upon admission at TCM and WM hospitals were cough (99.3% vs. 98.6%), rales (84.8% vs. 75.0%), phlegm (83.3% vs. 49.1%), and fever (74.9% vs. 84.0%) in frequency. Patients admitted to WM hospitals had symptoms and signs for a longer period prior to admission than patients admitted to TCM hospitals. Testing to identify etiologic agents was performed in 1140 cases (88.4%). Intravenous antibiotics were administered in 99.3% (595/598) of cases in TCM hospitals and in 98.6% (699/700) of cases in WM hospitals. Besides, Chinese herbal extract injection was used more frequently in TCM hospitals (491 cases, 82.1%) than in WM hospitals (212 cases, 30.3%) (p < 0.01). At discharge, 818 cases (63.0%) were clinically cured, with a significant difference between the cure rates in TCM (87.6%) and WM hospitals (42.0%) (OR = 9.8, 95% confidence interval (CI): 7.3 ~ 12.9, p < 0.01). Pathogen and previous medical history were more likely associated with the disappearance of rales (OR = 7.2, 95% CI: 4.8 ~ 10.9). Adverse effects were not reported from the medical records.
Intravenous use of antibiotics is highly prevalent in children with community-acquired pneumonia regardless of aetiology. There was difference between TCM and WM hospitals with regard to symptom profile and the use of antibiotics. Intravenous use of herbal injection was higher in TCM hospitals than in WM hospitals. Most of the cases were diagnosed based on clinical signs and symptoms without sufficient confirmation of aetiology. Audit of current practice is urgently needed to improve care.
在中国，儿童社区获得性肺炎很常见。为了了解当前的临床特点和实践情况，我们进行了一项横断面研究，以分析中国东部 8 个城市儿童肺炎的护理质量。
2010 年 1 月 1 日至 12 月 31 日，我们从 8 家中医院和 5 家西医院连续采集了病例，每家医院每个季节采集 25 例（共 100 例），2010 年 2 月、5 月、8 月和 11 月（每个季节采集 25 例，全年共采集 100 例）。使用预先设计的病例报告表从医院病历中提取数据。
共收集并分析了 1298 例病例。中医院和西医院入院时的症状和体征为咳嗽（99.3%比 98.6%）、啰音（84.8%比 75.0%）、痰（83.3%比 49.1%）和发热（74.9%比 84.0%）。在入院前，与中医院相比，西医院患者的症状和体征持续时间更长。在 1140 例（88.4%）患者中进行了病因检测。在中医院，99.3%（595/598）的病例使用了静脉抗生素，而在西医院，98.6%（699/700）的病例使用了静脉抗生素。此外，与西医院（212 例，30.3%）相比，中医院（491 例，82.1%）更常使用中药提取物注射剂（p<0.01）。出院时，818 例（63.0%）临床治愈，中医院（87.6%）和西医院（42.0%）的治愈率有显著差异（OR=9.8，95%CI：7.312.9，p<0.01）。病原体和既往病史与啰音消失更相关（OR=7.2，95%CI：4.810.9）。病历中未报告不良反应。
无论病因如何，儿童社区获得性肺炎静脉使用抗生素的情况都很普遍。中医院和西医院在症状特征和抗生素使用方面存在差异。中医院静脉使用中药注射剂的比例高于西医院。大多数病例是根据临床症状和体征诊断的，没有充分确认病因。迫切需要对现行实践进行审核，以改善护理。
