6个月以下患细支气管炎的婴儿在发病后5天内最有可能需要重大医疗干预。
Infants under 6 months with bronchiolitis are most likely to need major medical interventions in the 5 days after onset.
作者信息
Pruikkonen H, Uhari M, Dunder T, Pokka T, Renko M
机构信息
Department of Paediatrics, University Hospital of Oulu, University of Oulu, Oulu, Finland.
出版信息
Acta Paediatr. 2014 Oct;103(10):1089-93. doi: 10.1111/apa.12704. Epub 2014 Aug 29.
AIM
This study examined the need for, and timing of, major medical interventions (MMIs) in infants under 6 months of age with bronchiolitis.
METHODS
We reviewed the medical records of 353 children who visited our emergency department with bronchiolitis. MMI was defined as the need for any of the following interventions during admission: supplementary oxygen, intravenous fluids, intravenous antibiotics or admission to the intensive care unit.
RESULTS
Altogether 19% of the 353 patients required a MMI and 3% had apnoea. The patients with apnoea were all under 2 months of age, and 90% had a respiratory syncytial virus (RSV) infection and 40% had been born prematurely. The risk of needing a MMI continued for up to 5 days after disease onset. A positive RSV test predicted a MMI with an odds ratio (OR) of 11.5 (95% CI 2.6-50.5), and a fever of over 38°C predicted a MMI with an OR of 3.5 (95% CI 1.4-8.8). Each 1% increase in the initial oxygen saturation value was associated with a decreased risk of MMI (OR 0.7, 95% CI 0.6-0.8).
CONCLUSION
Infants under 6 months of age with bronchiolitis were most likely to need MMIs in the first 5 days after disease onset.
目的
本研究调查了6个月以下毛细支气管炎婴儿对重大医疗干预（MMIs）的需求及时机。
方法
我们回顾了353名因毛细支气管炎到我院急诊科就诊儿童的病历。MMI定义为住院期间需要以下任何一种干预措施：补充氧气、静脉输液、静脉使用抗生素或入住重症监护病房。
结果
353例患者中共有19%需要MMI，3%出现呼吸暂停。呼吸暂停患者均为2个月以下婴儿，90%感染呼吸道合胞病毒（RSV），40%为早产儿。发病后长达5天内都有需要MMI的风险。RSV检测呈阳性预测MMI的比值比（OR）为11.5（95%可信区间2.6 - 50.5），体温超过38°C预测MMI的OR为3.5（95%可信区间1.4 - 8.8）。初始血氧饱和度值每增加1%，MMI风险降低（OR 0.7，95%可信区间0.6 - 0.8）。
结论
6个月以下毛细支气管炎婴儿在发病后的前5天最有可能需要MMI。
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