小儿社区获得性肺炎并发败血症72例临床分析_临床医学论文.docVIP

小儿社区获得性肺炎并发败血症72例临床分析_临床医学论文 小儿社区获得性肺炎并发败血症72例临床分析_临床医学论文 【摘要】 目的 了解社区获得性肺炎为原发疾病的患儿并发败血症的临床特点,血培养及药物敏感情况，县级医院和中心城市的病原菌的异同,探讨社区获得性肺炎和败血症之间的关系。方法 对蒲江县人民医院和成都市第三人民医院近2年来收治的507例社区获得性肺炎进行常规血培养并对败血症临床特点及血培养和药敏情况进行分析。结果 在72例确诊败血症的患儿中≤1岁婴儿占65.27%,有营养性疾病的占39.50%,有先天性基础疾病的占20.83%。所有患儿中62.50%有发热,79.16%有精神差、纳差。血培养检出菌株中以革兰阳性球菌最多占61.11%,且以表皮葡萄球菌最多,革兰阴性杆菌27株占39.50%,以社区获得性肺炎克雷伯菌最多。结论 婴幼儿有营养缺乏性疾病等基础疾病者机体免疫功能低下,从而导致肺部感染易向全身扩散并发败血症;且小儿社区获得性肺炎并发败血症临床表现缺乏特异性。 【关键词】 社区获得性肺炎;并发症;败血症;儿童 　　[Abstract] Objective To investigate the community-acquired and pneumonia in children the clinical features,blood culture and drug-sensitive cases,county-level hospitals and central cities of the similarities and differences between pathogens and explore community-acquired pneumonia and septicemia of relations.Methods Pujiang County Peoples Hospital and Chengdu Third Peoples Hospital treated the past two years,507 community-acquired pneumonia and septicemia,routine blood culture and blood culture and clinical features of drug sensitivity analysis.Results In 72 cases of septicemia in children diagnosed in the ≤ 1-year-old infants accounted for 65.27%,nutritional diseases accounted for 39.50%,congenital underlying diseases accounted for 20.83%All children in the 62.50% had fever and many have mental difference,anorexia detection of blood culture isolates to a maximum of Gram-positive cocci accounted for 61.11%,and to a maximum of staphylococcus epidermidis,27 Gram-negative bacilli accounted for 39.50%,to a maximum of pneumonia cray research bacteria.Conclusion Infant nutritional deficiency diseases,the basis of illness of the immune dysfunction,leading to lung infections easily spread to the body of septic shock;and the pediatric community-acquired pneumonia,and septicemia show a lack of specificity. 　　[Key words] community-acquired pneumonia;complications;septicemia;child 　　败血症是小儿严重感染性疾病之一,许多文献资料显示[1],小儿时期败血症以呼吸道感染较为常见。按照我国儿童社区获得性肺炎诊断治疗方案确定的诊断标准[2],现将2008年2月至2009年2月蒲江县人民医院儿科(二等乙级)收治的和成都市第三人民医院儿科(三等甲级)收治住