儿童社区获得性肺炎的预后预测因素

Dina H. Hamed, Amira M Sabry, Neama Al-Amir, Iman Abdelaziz
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摘要

鉴于社区获得性肺炎对这一特定年龄组的临床、社会和经济重要性,社区获得性肺炎(CAP)是发展中国家和发达国家婴儿和儿童最常见的感染之一。目的探讨影响CAP临床、实验室和放射学预后的最重要因素。患者和方法本前瞻性队列研究纳入了2016年11月至2017年2月在开罗大学儿童医院儿科因CAP住院的120例患者,年龄2-59个月。评估病史、人口统计学、临床、实验室[全血细胞计数、c反应蛋白(CRP)、尿素、肌酐、钠、随机血糖、痰和血培养]和放射学资料。结果纯母乳喂养史与患者年龄、体重、入院时pO2较低及需要入住ICU之间存在统计学意义的相关关系。此外,患者的身高、体温、呼吸频率、血红蛋白、总白细胞计数和CRP、血培养和胸片表现以及住院时间之间也存在显著相关性。结论体重、身高、体温、呼吸频率、意识水平、初始氧饱和度、毛细血管充盈时间、搏动是否存在与CAP预后密切相关,血红蛋白水平、白细胞总数、CRP、血培养、动脉血气参数等实验室指标及胸片表现也与CAP预后密切相关。
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Outcome predictors of community-acquired pneumonia in children
Background Community-acquired pneumonia (CAP) is one of the most common infections of infants and children in developing and developed countries, given the clinical, social, and economic importance of CAP for this specific age group. Aim To highlight the most important factors affecting the outcome of CAP either clinical, laboratory, or radiological. Patients and methods This prospective cohort study included 120 patients, aged 2–59 months admitted with CAP in the Pediatric Department, Children’s Hospital, Cairo University from November 2016 till February 2017. History, demographic, clinical, laboratory [complete blood count, C-reactive protein (CRP), urea, creatinine, sodium, random blood sugar, sputum and blood culture], and radiological data were assessed. Results A statistically significant relationship was detected between each of the history of exclusive breastfeeding, patient’s age, and weight as well as lower pO2 on admission and between the need for ICU admission. Also, significant correlation was noted between patients’ height, temperature, respiratory rate, hemoglobin, total leukocyte count and CRP, blood culture and chest radiographic finding, and between the duration of hospital admission. Conclusion Weight, height, temperature, respiratory rate, conscious level, initial O2 saturation, capillary filling time, and presence of crepitation were closely related to the CAP outcome as well as, some laboratory findings such as hemoglobin level, total leukocyte count, CRP, blood culture, arterial blood gas parameters, and the chest radiographic finding.
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