儿童社区获得性肺炎局部并发症的影响因子评估

摘要

目的 评估儿童社区获得性肺炎局部并发症(胸腔积液、坏死性肺炎等)的影响因素.方法 回顾性分析2015年3月～2016年3月收治的101例肺炎患儿的临床资料.患儿分为并发症肺炎组(C组31例)和无并发症肺炎组(N组70例).比较两组的人口统计学、临床和实验室数据.单变量和多变量分析预测因素相关性.结果 相比于N组,C组的住院时间和急性炎症反应更持久.C组患儿的单侧胸痛及院前抗炎药物治疗更常见(P=0.000,P=0.011).C组患儿C反应蛋白浓度、白细胞计数、外周血中性粒细胞均明显高于N组.抗炎药物累积剂量超过75.2mg/kg,并发症OR值增加2.0倍(OR 2.02,95％ CI 1.41～5.64;P=0.079).结论 胸痛、院前持续发热、急性炎症反应、尤其抗炎药物治疗与肺炎局部并发症显著相关.%objective The aim of the study was to evaluate factors that could predict the development of local complications (pleural effusion,necrotizing pneumonia) in children with community acquired pneumonia (CAP).Methods The clinical data of 101 children with pneumonia from March 2015 to March 2016 in our hospital were divided into no-complications pneumonia group (N group) and complications pneumonia group (C group).Demographic,clinical and laboratory data were prospectively collected and compared.Univariate and multivariate analyses were performed to identify factors associated with local complications of CAP.Results The long length of hospital stay,acute inflammation,unilateral chest pain and pre-hospital anti-inflammatory medication of C group were more common than that of N group.Children with complicated CAP had a significantly higher serum CRP concentration as well as higher WBC and neutrophil count.Anti-inflammatory drugs cumulative dose were more than 75.2 mg/kg.The complications OR value increased 2.0 times (OR 2.02,95％ CI 1.41～ 5.64;p=0.079).Conclusion Duration of fever,chest pain,acute inflammation,especially the anti-inflammatory drug treatment are associated with significant pneumonia local complications.