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目的:通过奉贤区中心医院市六分院反复肺炎患儿发病率、病因、诊断的分析,了解患儿基础疾病的构成﹑反复肺炎的临床特点﹑疾病转归。方法:2007年1月～2008年12月期间,出院诊断为肺炎的患儿共1 832例。诊断依据:有咳嗽、喘息﹑气促或呼吸困难等症状,体检肺部听诊闻及中小湿啰音或哮鸣音,胸X线片见肺部浸润阴影,其中血白细胞>9.6×109/L为192例(10.4%),C反应蛋白(CRP)>5.0 mg/L为203例(11.1%),且有96例(5.2%)满足反复肺炎诊断标准。通过归纳病史﹑症状和体检结果,并结合胸X线片﹑螺旋CT﹑高分辨率CT(HRCT)﹑MRI﹑肺功能﹑心超﹑免疫学测定等检查。结果:96例反复肺炎患儿中有基础病变者达93.8%,其中以先天性心脏病最常见,其次为呼吸道吸入、支气管肺发育不良、哮喘、营养不良、副鼻窦炎、支气管异物、血液恶性肿瘤、气管支气管狭窄、先天性喉鸣。并且,不同年龄组的病因有所不同,2岁以下居前5位的基础疾病为先天性心脏病、呼吸道吸入、支气管肺发育不良、营养不良、气管支气管狭窄、先天性喉鸣,而2岁以上居前5位的基础疾病为哮喘、副鼻窦炎、支气管异物、血液恶性肿瘤。结论:随着科学技术的开展,许多病因不明的反复肺炎患儿可得到确诊并获得及时治疗。
Objective: Through the analysis of the incidence, etiology and diagnosis of recurrent pneumonia in Six-point Hospital of Fengxian Central Hospital, to understand the basic characteristics of the disease in children, the clinical features of recurrent pneumonia, and the prognosis of the disease. Methods: From January 2007 to December 2008, 1832 children diagnosed as pneumonia were discharged. Diagnosis is based on: cough, wheezing, shortness of breath or breathing difficulties and other symptoms, physical examination of the lung auscultation and small and medium wet rales or wheeze, chest X ray film see the lung infiltration shadow, where white blood cells> 9.6 × 109 / L 203 cases (11.1%) were found in 192 (10.4%) patients with C reactive protein (CRP)> 5.0 mg / L, and 96 (5.2%) patients met the diagnostic criteria for recurrent pneumonia. Through the induction of medical history, symptoms and physical examination results, combined with chest X-ray, spiral CT, high resolution CT (HRCT), MRI, pulmonary function, cardiac ultrasound, immunological tests and other tests. Results: Of the 96 children with recurrent pneumonia, 93.8% of them had underlying lesions, of which congenital heart disease was the most common, followed by respiratory inhalation, bronchopulmonary dysplasia, asthma, malnutrition, sinusitis, bronchial foreign bodies, hematological malignancy Tumor, tracheobronchial stricture, congenital throat. And the causes of different age groups vary, the top 5 under 2 years old underlying diseases are congenital heart disease, respiratory inhalation, bronchopulmonary dysplasia, malnutrition, tracheobronchial stricture, congenital throat, and 2 years old The top five basic diseases above are asthma, sinusitis, bronchial foreign bodies and hematological malignancies. Conclusion: With the development of science and technology, many children with recurrent pneumonia with unknown etiology can be diagnosed and treated promptly.