重度腺病毒肺炎患儿预后不良相关危险因素

摘要

目的：了解重度腺病毒肺炎（SAP）患儿预后不良的相关危险因素，为临床诊疗及预后判断提供指导。方法采用回顾性分析方法，对2012年1月—2014年1月重庆医科大学附属儿童医院儿科病房确诊的91例 SAP住院患儿的临床资料进行统计分析。结果91例 SAP 住院患儿，预后不良23例（25．27％）。SAP 患儿预后不良危险因素单因素分析结果显示，发病年龄、患先心病等严重基础疾病、机械通气治疗、发生急性呼吸窘迫综合症（ARDS）、有肺不张等严重影像学改变、出现2个及2个以上肺外并发症与 SAP 预后不良密切相关（均 P ＜0．05）。多因素分析结果显示：患先心病等严重基础疾病、出现2个及2个以上肺外并发症是 SAP 预后不良的独立危险因素（均 P ＜0．05）。结论患有先心病等严重基础疾病、出现2个及2个以上肺外并发症是 SAP 预后不良的独立危险因素，在临床诊治过程中应积极进行干预，改善预后。%Objective To understand the risk factors for poor prognosis of severe adenovirus pneumonia (SAP)in children,and provide guidance for clinical diagnosis and prognosis.Methods Clinical data of 91 hospitalized children who diagnosed with SAP in Chongqing Children’s Hospital of Chongqing Medical University between January 2012 and January 2014 were analyzed retrospectively.Results Of 91 SAP children,23 (25.27%)had poor prognosis. Univariate analysis showed that risk factors for poor prognosis of SAP were age of onset,congenital heart disease and other serious underlying diseases,mechanical ventilation therapy,acute respiratory distress syndrome (ARDS), atelectasis and other serious radiological changes,and emergence of two and more extra-pulmonary complications (all P <0.05).Multivariate regression analysis showed that congenital heart disease and other serious underlying diseases,and emergence of two and more extra-pulmonary complications were independent risk factors for poor prognosis of SAP (all P <0.05).Conclusion Congenital heart disease and other serious underlying diseases,emer-gence of two and more extra-pulmonary complications are independent risk factors for poor prognosis of SAP,active intervention should be conducted during the process of clinical diagnosis and treatment,so as to improve the prognosis.