中国感染控制杂志2025，Vol.24Issue(7)：932-939,8.DOI:10.12138/j.issn.1671-9638.20256861
儿童重症百日咳55例临床分析
Clinical analysis of 55 children with severe pertussis
摘要
Abstract
Objective To investigate the clinical characteristics of severe pertussis in children.Methods Clinical data of 55 children with severe pertussis and admitted to the pediatric intensive care unit(PICU)of Maternal and Child Heath Hospital of Hubei Province from January 2022 to May 2024 were retrospectively analyzed.Patients were grouped according to age(≤3-month group and＞3-month group),vaccination status,and mixed infection status,differences in clinical characteristics among different groups of pediatric patients were compared.Results 55 children with severe pertussis were aged 1 month and 5 days-9 years,all had severe pneumonia,54 children were improved and discharged from hospital,1 died.26 children(47.3％)were aged＜3 months,45 children(81.8％)were unvaccinated,and 47 children(85.5％)had mixed infection.The rates of post-vomiting cough and blood ex-change transfusion in children in ≤3-month group were lower those in＞3-month group(30.8％vs 58.6％;11.5％vs 34.5％,respectively);The rate of elevation of cerebrospinal fluid protein in children in ≤3-month group was higher than that in＞3-month group(61.5％vs 31.0％);The pre-admission disease course of children in ≤3-month group was shorter than that in＞3-month group([10.15±5.64]days vs[14.24±8.90]days),differences were all statistically significant(all P≤0.05).The absolute counts of lymphocyte in the vaccinated group was lower than that in the unvaccinated group([9.92±5.92]× 109/L vs[17.93±11.41]× 109/L,P＜0.05).The usage rate of gamma-globulin in children in the mixed infection group was higher than that in the simple infection group(87.2％vs 50.0％).The length of hospital stay([15.11±6.53]days vs[9.50±4.69]days),length of PICU stay([10.53±5.26]days vs[5.88±4.16]days),and macrolides antibiotic use days([8.36±4.21]days vs[5.00±2.73]days)in children in the mixed infection group were all longer than those in the simple infection group,differences were all statistically significant(all P＜0.05).No independent influencing factors were found to prolong the length of PICU stay in children with severe pertussis.Conclusion Severe pertussis mostly occurs in unvaccinated children aged ≤3 months,with a high incidence of mixed infection,all presenting as severe pneumonia.Vaccination status,mixed infection,and complications are key factors affecting prognosis.关键词
百日咳/儿童/重症肺炎/影响因素/换血治疗Key words
pertussis/child/severe pneumonia/influencing factor/blood exchange transfusion分类
医药卫生引用本文复制引用
刘柳英,夏治,汤文,石步云..儿童重症百日咳55例临床分析[J].中国感染控制杂志,2025,24(7):932-939,8.基金项目
湖北省自然科学基金项目(2021CFB551) （2021CFB551）
