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急性细支气管炎患儿的临床、实验室及影像学检查结果与治疗方法评估:一家三级中心的经验

Evaluation of the Clinical, Laboratory and Radiology Findings and Treatment Methods of Children with Acute Bronchiolitis: Experience of a Tertiary Center.

作者信息

Ugur Cuneyt, Somuncu Elif, Demirci Taha

机构信息

Department of Pediatrics, University of Health Sciences Türkiye, Konya City Health Application and Research Center, Konya, Türkiye.

Department of Pediatrics, Van Training and Research Hospital, Van, Türkiye.

出版信息

Sisli Etfal Hastan Tip Bul. 2024 Apr 5;58(1):102-108. doi: 10.14744/SEMB.2023.95605. eCollection 2024.

Abstract

OBJECTIVES

The aim of this study is to determine the factors affecting the duration of hospitalization and causing the initiation of antibiotics in children with acute bronchiolitis.

METHODS

This study was conducted retrospectively in Konya Training and Research Hospital. Demographic data, clinical features, laboratory and radiological findings, treatment methods and duration of hospitalization of 102 patients followed up in the pediatric service between September 2017 and April 2019 (in autumn, winter and spring seasons) were recorded from patient files.

RESULTS

67 (65.7%) of 102 patients were male, and 35 (34.3%) were female. Median age was 6.5 (11.0) months. According to Wang bronchiolitis clinical scoring, 36 (35.3%) of the patients were mild, 51 (50.0%) were moderate, 15 (14.7%) were severe bronchiolitis The most common agents in polymerase chain reaction (PCR) were respiratory syncytial virus 60 (58.8%), influenza virus 20 (19.6%), rhinovirus 15 (14.7%), bocavirus 15 (14.7%) and parainfluenza virus 12 (11.7%). The median duration of hospitalization was 7.0 (4.0) days. Forty-two (41.2%) of the patients were hospitalized for ≤5 days, and 60 (58.8%) were hospitalized for >5 days. Duration of hospitalization was significantly and positively correlated with crepitant crackles, leukocytosis, neutrophilia, and coinfection with influenza virus (p=0.036, p=0.034, p=0.028, p=0.036, respectively). Duration of hospitalization was significantly and negatively correlated with pH and increased aeration (p=0.002, p=0.003, respectively) Antibiotic initiation was significantly and positively correlated with wheezing, crepitant crackles, leukocytosis, and neutrophilia (p=0.033, p=0.013, p=0.028, p=0.002, respectively).

CONCLUSION

A significant relationship was found between crepitant crackles in physical examination, respiratory acidosis in laboratory, co-infection with influenza virus detected by PCR and hospitalization for more than 5 days. A significant relationship was determined between wheezing or crepitant crackles in physical examination, leukocytosis or neutrophilia in laboratory and the initiation of antibiotic.

摘要

目的

本研究旨在确定影响急性细支气管炎患儿住院时间及导致抗生素使用的因素。

方法

本研究在科尼亚培训与研究医院进行回顾性研究。从2017年9月至2019年4月(秋冬春季节)儿科服务中随访的102例患者的病历中记录人口统计学数据、临床特征、实验室和影像学检查结果、治疗方法及住院时间。

结果

102例患者中67例(65.7%)为男性,35例(34.3%)为女性。中位年龄为6.5(11.0)个月。根据王氏细支气管炎临床评分,36例(35.3%)患者为轻度,51例(50.0%)为中度,15例(14.7%)为重度细支气管炎。聚合酶链反应(PCR)检测中最常见的病原体为呼吸道合胞病毒60例(58.8%)、流感病毒20例(19.6%)、鼻病毒15例(14.7%)、博卡病毒15例(14.7%)和副流感病毒12例(11.7%)。中位住院时间为7.0(4.0)天。42例(41.2%)患者住院时间≤5天,60例(58.8%)患者住院时间>5天。住院时间与湿啰音、白细胞增多、中性粒细胞增多及流感病毒合并感染显著正相关(分别为p = 0.036、p = 0.034、p = 0.028、p = 0.036)。住院时间与pH值及肺野透亮度增加显著负相关(分别为p = 0.002、p = 0.003)。抗生素使用与喘息、湿啰音、白细胞增多及中性粒细胞增多显著正相关(分别为p = 0.033、p = 0.013、p = 0.028、p = 0.002)。

结论

体格检查中的湿啰音、实验室检查中的呼吸性酸中毒、PCR检测出的流感病毒合并感染与住院时间超过5天之间存在显著相关性。体格检查中的喘息或湿啰音、实验室检查中的白细胞增多或中性粒细胞增多与抗生素使用之间存在显著相关性。

相似文献

本文引用的文献

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Update on current views and advances on RSV infection (Review).关于 RSV 感染的最新观点和进展(综述)。
Int J Mol Med. 2020 Aug;46(2):509-520. doi: 10.3892/ijmm.2020.4641. Epub 2020 Jun 15.
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Respiratory syncytial virus: diagnosis, prevention and management.呼吸道合胞病毒:诊断、预防与管理
Ther Adv Infect Dis. 2019 Jul 29;6:2049936119865798. doi: 10.1177/2049936119865798. eCollection 2019 Jan-Dec.
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Viral bronchiolitis.病毒性细支气管炎
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Multiple viral respiratory pathogens in children with bronchiolitis.毛细支气管炎患儿中的多种病毒性呼吸道病原体。
Acta Paediatr. 2009 Jan;98(1):123-6. doi: 10.1111/j.1651-2227.2008.01023.x. Epub 2008 Sep 9.

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