摘要
Abstract
Objective To analyze the differences of clinical diagnosis and treatment of severe pneumonia in leukemia children and non - leukemia children,in order to improve the level of diagnosis and treatment of children with severe pneumonia and reduce mortality. Methods A retrospective study was made on the clinical data of 91 children with severe pneumonia who were admitted into the First Affiliated Hospital of Guangzhou Medical University from 2010 to 2013. According to whether leukemia existed,the children were divided into two groups:leukemia group( n = 30)and non - leukemia group( n = 61). General condition,high risk factors, clinical manifestations, complications, laboratory examination and treatment methods were observed. Results Children of leukemia group suffered from fever and shortness of breath as main symptoms,and most of the cases were absent of other symptoms and positive signs;complications were mainly stomatitis,intestinal infection,urinary tract infections,infectious shock,respiratory failure,heart failure and intracranial infection;pathogens were mainly pseudomonas aeruginosa,fungus and klebsiella pneumoniae;blood routine examination mostly revealed white blood cell count reduced,lack of granulocyte,CRP elevated;blood gas analysis and electrolyte analysis mostly revealed metabolic acidosis, respiratory acidosis,hypoxemia,hypokalemia,hyponatremia;there were 6 cases of type 1 respiratory failure and 6 cases of type 2 respiratory failure;chest imaging revealed multiple nodular high - density shadow. After treatment,20 cases were cured,and 8 cases had marked effect,with a total effective rate 93. 3% ;2 cases died,and the mortality rate was 6. 7% . Children of non -leukemia group suffered from cough, fever, shortness of breath, wheezing and had more positive signs and symptoms;complications were mainly pyothorax,septic shock,heart failure and respiratory failure;pathogens were mainly staphylococcus aureus,deputy flu bloodthirsty bacillus and mycoplasma pneumoniae;blood routine examination mostly revealed white blood cell count elevated and CRP elevated;blood gas analysis and electrolyte analysis mostly revealed metabolic acidosis,respiratory acidosis,hypoxemia,hypokalemia and hyponatremia;there were 8 cases of type 1 respiratory failure and 5 cases of type 2 respiratory failure;chest imaging revealed localized patchy consolidation shadows in single lung in most cases. After treatment, 56 cases cured,and 2 cases saw efficacy,with a total effective rate of 95. 1% ;3 cases died treatment with a mortality rate of 4. 9%. Conclusion Leukemia children and non - leukemia children are distinctly different in clinical manifestations,pathogen and treatment. Early recognition of high risk factors for the disease attack and correct treatment of infection during chemotherapy are important factors for the success of chemotherapy.关键词
肺炎/白血病/儿童/诊断/治疗/体征和症状Key words
Pneumonia/Leukemia/Child/Diagnosis/Therapy/Signs and symptoms分类
医药卫生
