儿童感染后咳嗽病原学调查以及家庭雾化的疗效分析(1)
【摘要】 目的：调查2018年本院引起儿童感染后咳嗽的常见病原菌并探讨家庭雾化对儿童感染后咳嗽的疗效。方法：选择本院2018年1-12月治愈出院的支气管肺炎患儿127例。按照患儿家长是否愿意进行家庭雾化分为干预组(n=65)与对照组(n=62)。干预组使用加压雾化机进行每日家庭雾化，对照组无特殊治疗。分析两组导致感染后咳嗽的常见病原，比较出院后7、14及21 d两组疗效。结果：干预組剔除5例，实为60例;对照组剔除3例，实为59例。两组感染的常见病原均为金黄色葡萄球菌、流感病毒、副流感病毒及肺炎支原体，其中金黄色葡萄球菌比例最高。干预组出院7、14及21 d疗效比较，差异均有统计学意义(P<0.01);干预组出院7、14及21 d疗效均优于对照组(P<0.01)。结论：金黄色葡萄球菌与流感病毒为引儿童感染后咳嗽的常见病原，使用家庭雾化能有效控制感染后咳嗽患儿的临床症状。
【关键词】 儿童感染后咳嗽 病原学调查 家庭雾化
[Abstract] Objective： To investigate the common pathogens of children’s post-infectious cough in our hospital in 2018 and explore the effect of home atomization on children’s post-infectious cough. Method： A total of 119 children with bronchial pneumonia cured and discharged in our hospital from January to December 2018 were selected. They were divided into the intervention group (n=65) and the control group (n=62) according to whether the parents were willing to carry out home atomization. The intervention group was given daily home atomization by pressurized atomization machine， while the control group received no special treatment. Common pathogens causing post-infection cough were analyzed in the two groups， the efficacy of 7， 14 and 21 d after discharge were compared.Result： In the intervention group， 5 cases were excluded， which was actually 60 cases. In the control group， 3 cases were excluded， which was actually 59 cases. The common pathogens in the two groups were staphylococcus aureus， influenza virus， parainfluenza virus and mycoplasma pneumoniae， among which staphylococcus aureus had the highest proportion. The therapeutic effect on 7， 14 and 21 d after discharge in the intervention group were compared， the differences were statistically significant (P<0.01). The therapeutic effect of the intervention group on 7， 14 and 21 d after discharge were better than those of the control group (P<0.01). Conclusion： Staphylococcus aureus and influenza virus are the common pathogens of children’s post-infectious cough. Home atomization can effectively control the clinical symptoms of children with post-infectious cough. [Key words] Children’s post-infectious cough Etiology investigation Home atomizationFirst-author’s address： Boai Hospital of Zhongshan Affiliated to Southern Medical University， Zhongshan 528400， China
感染后咳嗽(post-infection cough，PIC)是引起幼儿和学龄前儿童慢性咳嗽的常见原因，也是患儿门诊就诊最常见的原因之一。该病是指呼吸道感染的急性期症状消失后，患儿仍然存在刺激性咳嗽，但是胸片检查无明显异常者，感染后咳嗽一般会自愈，且咳嗽时间不超过8周[1]。引起PIC的特异性病原体仍有待明确，目前认为主要是呼吸道病毒(特别是呼吸道合胞病毒、流感病毒、副流感病毒和腺病毒)、肺炎支原体、肺炎衣原体及部分细菌等。其直接诱因主要为气道上皮受损，而下呼吸道的一过性炎症可能是出现感染后咳嗽的重要原因，此外，有研究指出呼吸道病毒感染后可诱发气道可逆性气道高反应性，气道高反应性的时间与病毒感染后气道上皮的修复时间相关[2]。临床上常规止咳药物、抗生素治疗此类咳嗽效果不佳，严重影响患儿学习、生活，也因为反复门诊就诊而增加门诊工作量。本研究分析了致PIC的相关病原，同时对PIC患儿进行跟踪随访，现报道如下。, 百拇医药(刘翔腾 王桂兰 容嘉妍 黄娟 林嘉镖 黄东明 林汉炼 王冰洁)
【关键词】 儿童感染后咳嗽 病原学调查 家庭雾化
[Abstract] Objective： To investigate the common pathogens of children’s post-infectious cough in our hospital in 2018 and explore the effect of home atomization on children’s post-infectious cough. Method： A total of 119 children with bronchial pneumonia cured and discharged in our hospital from January to December 2018 were selected. They were divided into the intervention group (n=65) and the control group (n=62) according to whether the parents were willing to carry out home atomization. The intervention group was given daily home atomization by pressurized atomization machine， while the control group received no special treatment. Common pathogens causing post-infection cough were analyzed in the two groups， the efficacy of 7， 14 and 21 d after discharge were compared.Result： In the intervention group， 5 cases were excluded， which was actually 60 cases. In the control group， 3 cases were excluded， which was actually 59 cases. The common pathogens in the two groups were staphylococcus aureus， influenza virus， parainfluenza virus and mycoplasma pneumoniae， among which staphylococcus aureus had the highest proportion. The therapeutic effect on 7， 14 and 21 d after discharge in the intervention group were compared， the differences were statistically significant (P<0.01). The therapeutic effect of the intervention group on 7， 14 and 21 d after discharge were better than those of the control group (P<0.01). Conclusion： Staphylococcus aureus and influenza virus are the common pathogens of children’s post-infectious cough. Home atomization can effectively control the clinical symptoms of children with post-infectious cough. [Key words] Children’s post-infectious cough Etiology investigation Home atomizationFirst-author’s address： Boai Hospital of Zhongshan Affiliated to Southern Medical University， Zhongshan 528400， China
感染后咳嗽(post-infection cough，PIC)是引起幼儿和学龄前儿童慢性咳嗽的常见原因，也是患儿门诊就诊最常见的原因之一。该病是指呼吸道感染的急性期症状消失后，患儿仍然存在刺激性咳嗽，但是胸片检查无明显异常者，感染后咳嗽一般会自愈，且咳嗽时间不超过8周[1]。引起PIC的特异性病原体仍有待明确，目前认为主要是呼吸道病毒(特别是呼吸道合胞病毒、流感病毒、副流感病毒和腺病毒)、肺炎支原体、肺炎衣原体及部分细菌等。其直接诱因主要为气道上皮受损，而下呼吸道的一过性炎症可能是出现感染后咳嗽的重要原因，此外，有研究指出呼吸道病毒感染后可诱发气道可逆性气道高反应性，气道高反应性的时间与病毒感染后气道上皮的修复时间相关[2]。临床上常规止咳药物、抗生素治疗此类咳嗽效果不佳，严重影响患儿学习、生活，也因为反复门诊就诊而增加门诊工作量。本研究分析了致PIC的相关病原，同时对PIC患儿进行跟踪随访，现报道如下。, 百拇医药(刘翔腾 王桂兰 容嘉妍 黄娟 林嘉镖 黄东明 林汉炼 王冰洁)
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