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《广州医药》编辑部
目的 探讨不同年龄段皮罗序列征患儿血气分析的特点、手术后机械通气时间和住院时间。方法 收集新生儿及非新生儿III度皮罗序列征(PRS)患儿各30例,PRS患儿入院后通过桡动脉进行采集血标本进行血气分析,比较2组血标本的 pH 值、PCO2 、PO2 、HCO-3、BE、乳酸、AG、A-aDO2的特点、手术后机械通气时间及住院时间。结果 新生儿组PCO2、HCO-3、BE、乳酸及A-aDO2高于非新生儿组,非新生儿组PO2及AG高于新生儿组。2组pH值、PO2、AG均在正常范围,机械通气及住院时间与乳酸呈正相关,与年龄呈负相关。结论 不同的年龄阶段,PRS患儿的动脉血气分析的结果不同,高乳酸与低年龄PRS患儿手术后机械通气时间及住院时间长。
Objective To investigate the characteristics of arterial blood gas analysis, time of mechanical ventilation and hospital stay in different age patients with Pirre Robin sequence (PRS). Methods Sixty children with III-grade PRS were divided into two groups according to their age, as neonate group and non-neonate group. The blood samples were collected from radial artery after admission for blood gas analysis, the characteristics of pH value, partial pressure of carbon dioxide (PCO2), partial pressure of blood oxygen (PO2), bicarbonate ion (HCO-3), base excess (BE), lactic acid (Lac), anion gap (AG) , alveolar artery oxygen pressure difference (A-aDO2) , postoperative mechanical ventilation time and hospital stay were compared between the two groups. Results The levels of PCO2, HCO-3, BE, Lac and A-aDO2 in neonate group were higher than those in non-neonate group, and the levels of PO2 and AG in non-neonate group were higher than those in neonate group. The pH value, PO2 and AG of the two groups were in the normal range. Post-operative mechanical ventilation time and hospital stay were positively correlated with Lac and negatively correlated with age. Conclusions In different age groups, the results of arterial blood gas analysis in PRS children were different, and the time of mechanical ventilation and hospital stay were longer in higher Lac level and younger patients with PRS.
目的 调查儿科急诊非急诊手术患儿输血后红细胞恢复的影响因素。方法 回顾2020年1月—2020年12月期间广州市妇女儿童医疗中心珠江新城院区儿科急诊1月~18岁患儿的输血情况,其中分为Hb提升达预期组(n=93),Hb提升未达预期组(n=156),根据年龄、性别、体质量、是否恶性肿瘤、是否发热、有无延迟输血、输血前血红蛋白水平、输注红细胞类型情况,分析输血疗效及影响因素。结果 2组患儿的性别、年龄、体质量、有无恶性肿瘤、是否发热、输血等待时间、输血前后血红蛋白值、输注红细胞悬液量以及有无及时输血均无统计学差异;输注红细胞类型组间存在显著差异,Hb提升未达预期组更多输注了洗涤红细胞悬液(13.5% vs 5.4%,P=0.044),输血后 Hb 值较低(中位数,73 g/L vs 84 g/L,P<0.001),变化 Hb 值较小(中位数,18 g/L vs 30 g/L,P<0.001),归因分析未发现影响因素。结论 输注洗涤红细胞可能是降低输血后红细胞提升的影响因素,输注洗涤红细胞时需严格输血指征同时注意红细胞提高预值的设定。
Objective To investigate the influencing factors of blood transfusion efficacy in patients without emergency operations in pediatric emergency.Methods A retrospective analysis of the blood transfusion of pediatric emergency children(1 month~ 18 year of age)in Zhujiang New Town Branch of Guangzhou Women and Children's Medical Center from January 2020 to December 2020 was carried out,patients were divided into Hb elevation up to expectation group(n=93)and Hb elevation not up to expectation group(n=156).The efficacy of blood transfusion and the factors affecting it were analyzed according to age,gender,body mass,with or without malignant tumor,whether fever was present,whether there was delayed transfusion,pre-transfusion hemoglobin level,and the type of red blood cells transfused.Results There were no significant differences in gender,age,weight,malignant tumor,fever,waiting time for blood transfusion,hemoglobin level before and after blood transfusion,infusion volume of red blood cell suspension and whether had timely blood transfusion between the two groups.Significant differences were found between groups of transfused red blood cell types,with more washed red blood cell suspensions transfused in the Hb elevation not meeting expectations group(13.5% vs 5.4%,P=0.044),which had lower post-transfusion Hb values(median,73 g/L vs 84 g/L,P<0.001),and smaller change Hb values(median,18 g/L vs 30 g/L,P<0.001),and attribution analysis did not reveal influencing factors.Conclusions Transfusion of washed red blood cell may be an influencing factor that reduces the RBCs elevation after transfusion.Attention should be paid to strict indications for washed red blood cell transfusion and setting the expected Hb level.
目的 分析不同年龄、不同季节河源市源城区呼吸道感染的病原学情况,指导临床用药。方法 回顾性研究2020年3月—2022年2月2 468例呼吸道感染的住院患儿,取咽部分泌物送广州达安临床检验中心进行呼吸道核酸六项检测并分析结果。包括:肺炎链球菌(Sp)、呼吸道合胞病毒(RSV)、卡他莫拉菌(MC)、流感嗜血杆菌(Hi)、肺炎支原体(LP)、腺病毒(ADV)。结果 (1)2 468例患儿的标本中阳性率52.8%,其中RSV最高,其他依次为Sp、Hi、MC、MP、ADV。而混合感染仅次于RSV。(2)婴儿组和幼儿组以RSV感染为主,在学龄前组和学龄组儿童中,以Sp感染为主,各病原体的混合感染组合很多,一种细菌合并一种病毒多见。(3)秋冬季是河源市源城区呼吸道感染的高发季节,RSV是秋冬季呼吸道感染最主要的病原体。结论 秋冬季节为河源市源城区呼吸道感染的高发季节,RSV为该季节的主要病原体。RSV也是婴幼儿组感染的主要致病菌,随着年龄增大,细菌感染导致的呼吸道疾病逐渐占优势。混合感染在各年龄组中均占比较高,值得临床诊疗的重视。
Objective To analyze the etiology of respiratory tract infection in Yuancheng District of Heyuan City ,which was in different ages and seasons,and to provide guidance of clinical drug usage.Methods Cases of 2 468 hospitalized children with respiratory tract infection from March 2020 to February 2022 were analyzed.The secretion from pharynx was collected and sent to Guangzhou Da’an Clinical Examination Center for six respiratory nucleic acid tests and then the results were analyzed,including Streptococcus pneumoniae(Sp),respiratory syncytial virus(RSV),Moraxella catarrhalis(MC),Haemophilus influenzae(Hi),Mycoplasma pneumonia(MP),adenovirus(ADV).Results The positive rate of 2 468 hospitalized children with respiratory tract infection was 52.8%,of which the highest was RSV,followed by Sp,Hi,MC,MP,ADV.Meanwhile the mixed infection rate was second to RSV.RSV infection was the main infection in infant group and early-aged children group,while in preschool group and school-aged group,Sp infection was the main infection.There were many mixed infection of pathogen,and one bacteria combined with one virus was more common.Respiratory tract infection had high incidence in autumn and winter in Yuancheng District of Heyuan City,RSV was the major pathogen.Conclusions Autumn and winter were the seasons with high respiratory tract infection incidence in Yuancheng District of Heyuan City,and RSV was the main pathogen in these two seasons.RSV was also the main pathogen of infant group infection.But with the increase of children’s age,bacterial infection became the main reason of respiratory tract diseases.Mixed infection accounts for a high proportion in all age groups,which should be valued in clinical diagnosis and treatment.
目的 调查与分析儿童结直肠息肉的临床特征及腹腔镜联合结肠镜下手术对其的治疗效果。方法 选择2019年2月—2021年10月在郑州大学附属儿童医院诊治的98例结直肠息肉患儿,记录患儿的临床特征,根据患儿的手术方法分为腹腔镜组(腹腔镜联合结肠镜下手术治疗,n=40)与结肠镜组(采用结肠镜手术治疗,n=58),对比不同手术方法的治疗效果、并发症发生率、疼痛视觉模拟评分法(VAS)评分、息肉复发与再手术率。结果 98例患儿中,息肉部位为直肠44例、横直肠38例、其他16例;息肉最大直径(1.65±0.24)cm;息肉单发83例、多发15例。腹腔镜组的围手术期指标比结肠镜组改善(P<0.05)。腹腔镜组术后7 d的感染、出血、肠穿孔、肠梗阻等并发症发生率为5.00%,低于结肠镜组的17.24%(P<0.05)。腹腔镜组术后1个月的总有效率为97.50%,高于结肠镜组的82.76%(P<0.05)。腹腔镜组术后1、3、7 d的疼痛VAS评分低于结肠镜组(P<0.05)。所有患儿术后随访1年,联合的息肉复发率与再次手术率为5.00%、2.50%,均低于结肠镜组的18.97%、13.79%(P<0.05)。结论 儿童结直肠息肉主要位于直肠、横直肠,多为单发,腹腔镜联合结肠镜下手术治疗能促进患儿康复,提高总体治疗效果,也能缓解患儿疼痛,减少并发症的发生,降低随访息肉复发率与再次手术率。
Objective To investigate and analyze the clinical features of children with colorectal polyps and the efficacy of laparoscopic surgery combined with colonoscopy. Methods A total of 98 children with colorectal polyps diagnosed and treated in our hospital from February 2019 to October 2021 were selected as subjects of this study. The clinical characteristics of all children were recorded,and they were divided into the laparoscopic group(laparoscopic surgery combined with colonoscopy,n=40)and the colonoscopy group(colonoscopy,n=58)according to the differences in surgical methods. The therapeutic effect,complication rate,VAS pain score,polyp recurrence and reoperation rate of different surgical methods were compared. Results Among the 98 children,the polyps of 44 cases were in rectum,38 cases in transverse rectum and 16 cases in other sites. The maximum diameter of polyp was(1. 65±0. 24)cm. Polyps were solitary in 83 cases and multiple in 15 cases. The perioperative indexes in the laparoscopic group were significantly improved compared with those in the colonoscopy group(P<0. 05). The incidence of postoperative complications such as infection,bleeding,intestinal perforation and intestinal obstruction was 5. 00% in the laparoscopy group,which was significantly lower than 17. 24% in the colonoscopy group(P<0. 05). The total effective rate of laparoscopic group was 97. 50% one month after operation,which was significantly higher than that of colonoscopy group(82. 76%,P<0. 05). The VAS pain score of the laparoscopic surgery group was significantly lower than that of the colonoscopy group at 1,3 and 7 days after surgery(P<0. 05). After 1 year of follow-up,the combined polyp recurrence rate and reoperation rate were 5. 00% and 2. 50%,which were significantly reduced compared with 18. 97% and 13. 79% in colonoscopy group(P<0. 05). Conclusions The main sites of colorectal polyps in children are rectum and transverse rectum,and most of them are solitary. Laparoscopic and colonoscopic surgery for colorectal polyps in children can promote the recovery of children,improve the overall treatment effect of patients,relieve the pain of children,reduce the occurrence of complications,and reduce the recurrence rate and reoperation rate of follow-up polyps in children.
目的 探讨特殊健康儿童预防接种评估及不良反应处理。方法 选取2018年1月–2022年12月经预防接种门诊主动筛选的出生日期在2004年6月1日—2022年6月1日的特殊健康儿童,收集临床资料,以此进行预防接种评估建议,随访不良反应。结果 本研究共纳入944例特殊健康儿童,其中精神发育迟滞231例(24.47%)、脑性瘫痪440例(46.61%)、先天愚型115例(12.18%)、癫痫74例(7.83%)、先天性心脏病54例(5.72%)、唐氏综合征30例(3.18%)。其中男、女分别有519例(54.98%)、425例(45.02%)。在特殊健康儿童中,建议可正常接种疫苗918例(97.25%),建议接种灭活疫苗但避免接种减毒活疫苗8例(0.85%),建议暂缓接种所有疫苗18例(1.91%)。建议接种疫苗的特殊健康儿童中,已接种疫苗926例(98.09%),接种灭活疫苗842例(89.19%),接种减毒活疫苗612例(64.83%);926例儿童共接种疫苗8 480剂次,其中灭活疫苗6 770剂次、减毒活疫苗1 770剂次;62例儿童进行68剂次疫苗接种后出现不良反应(包括局部反应15例次、全身反应53例次),总发生率为8.02‰(68/8 480),其中灭活疫苗、减毒活疫苗发生率分别为6.79‰(46/6770)、1.29%(22/1 710)。所有不良反应案例经处理,除口干1例处理后好转外,其他均达治愈,治愈率达98.53%(67/68)。结论 特殊健康儿童经医学评估后大多可接种疫苗,接种后不良反应发生风险在可控范围内。
Objective To discuss the evaluation of vaccination and treatment of adverse reactions in healthy special children. Methods From January 2018 to December 2022,healthy special children with birth dates from June 1,2004 to June 1,2022 who were screened by the vaccination clinic were selected. Clinical data were collected to conduct vaccination assessment recommendations and follow up adverse reactions. Results A total of 944 healthy special children were included in this study,including 231 cases(24. 47%)of mental retardation,440 cases(46. 61%)of cerebral palsy,115 cases(12. 18%)of congenital foolishness,74 cases(7. 83%)of epilepsy,54 cases(5. 72%)of congenital heart disease and 30 cases(3. 18%)of Down syndrome. There were 519 males(54. 98%)and 425 females(45. 02%). Among the healthy special children,918 cases(97. 25%)were recommended to get vaccinated normally,8 cases(0. 85%)were recommended to be vaccinated with inactivated vaccine but avoid to be vaccinated with attenuated live vaccine,and 18 cases(1. 91%)were recommended to suspend all vaccination. Among the special healthy children recommended for vaccination,926(98. 09%)had been vaccinated,842(89. 19%)had been vaccinated with inactivated vaccine,and 612(64. 83%)had been vaccinated with live attenuated vaccine. A total of 8 480 doses of vaccines were administered to 926 children,including 6 770 doses of inactivated vaccines and 1 770 doses of attenuated live vaccines. Adverse reactions occurred in 62 children after 68 doses of vaccination(including 15 cases of local reactions and 53 cases of systemic reactions),with a total incidence of 8. 02 ‰(68/8480). The incidences of inactivated vaccine and attenuated live vaccine were 6. 79 ‰(46/6 770)and 1. 29%(22/1710),respectively. All cases of adverse reactions were treated and basically cured,with a cure rate of 98. 53%(67/68),except for the case of dry mouth. Conclusions Most of the healthy special children can be vaccinated after medical evaluation,and the risk of adverse reactions after vaccination is controllable.
目的 观察脑性瘫痪(CP)伴营养不良患儿进行系统性饮食调整的效果。方法 2015年1月—2022年1月我院收治以CP伴营养不良患儿80例,以随机数字表法分为对照组和研究组各40例,常规护理指导用于对照组,系统性饮食调整护理用于研究组。比较2组患儿在干预前、后的生化指标(白蛋白、血红蛋白、肌酐、低密度脂蛋白水平)、身体指标(体质量、身高、体质指数、腹部皮下脂肪厚度)、肠内营养混悬液使用剂量及饮食行为能力评分和患儿监护人对干预的满意率。结果 干预后2组的生化指标可见明显变化,其中研究组与对照组相比,白蛋白、血红蛋白、肌酐指标提升更多更平稳,而低密度脂蛋白研究组较对照组相比,降低更多更平稳,(P<0.01)。在干预后两组间的身体指标可见明显变化,其中研究组与对照组相比,体质量、体质指数、腹部皮下脂肪厚度较干预前增加更多更平稳,而低密度脂蛋白研究组较对照组相比,降低更多更平稳,(P<0.01)。在干预后2组的肠内营养混悬液使用剂量及饮食行为能力评分较干预前可见明显变化,其中研究组与对照组相比,肠内营养混悬液使用剂量及饮食行为能力降低更多更平稳(均P<0.05)。研究组监护人对干预的满意率高于对照组(P<0.05)。结论 在CP伴营养不良患儿中,开展有效的系统性饮食调整干预,可有效改善患儿的生化指标,提升各项身体指标,减少肠内营养混悬液的使用剂量,改善饮食行为能力,获得患儿监护人的认可,效果理想。
Objective To observe the effect of systematic diet adjustment in children with cerebral palsy(CP)and malnutrition.Methods A total of 80 CP children with malnutrition treated in our hospital(from January 2015 to January 2022)were divided into two groups by random number table method.Control group received routine nursing guidance and study group received systematic diet adjustment nursing.The biochemical indexes(albumin,hemoglobin,creatinine,low-density lipoprotein levels),physical indexes(weight,height,body mass index,abdominal subcutaneous fat thickness),the dosage of enteral nutritional suspension and the score of dietary behavior ability were compared between the two groups before and after the intervention.The satisfaction rate of the children's families with the intervention was evaluated.Results After the intervention,the biochemical indexes of the two groups showed significant changes.Compared with the control group,the indexes of albumin,hemoglobin and creatinine in the study group increased more and more stably,while the index of low-density lipoprotein in the study group decreased more and more stably(P<0.01).After the intervention,the physical indexes of the two groups showed significant changes.Compared with the control group,the weight,body mass index and abdominal subcutaneous fat thickness of the study group increased more and more stably than before the intervention,while the low-density lipoprotein study group decreased more and more stably(P<0.01).After the intervention,the dosage of enteral nutritional suspension and the score of dietary behavior ability in the two groups showed significant changes compared with those before the intervention.Compared with the control group,the immune indexes in the study group increased more and more stably,while the dosage of enteral nutritional suspension and the score of dietary behavior ability in the study group decreased more and more stably(P<0.05).The satisfaction rate of family members in the study group was higher than that in the control group(P<0.05).Conclusions In children with CP and malnutrition,carrying out effective systematic diet adjustment intervention can significantly improve the biochemical indexes of children,improve various physical indexes,improve immune ability,reduce the dosage of enteral nutritional suspension,improve dietary behavior,and obtain the recognition of children's family members,which has ideal effects.
目的 探讨广州地区儿童2019新型冠状病毒(2019 novel coronavirus, 2019-nCoV)感染筛查/疑似病例的流行病学特点、发病特点、可能的原因及防控建议。方法 回顾性分析2020年1月20日—2020年2月29日广州市唯一一家儿童2019-nCoV感染隔离定点医疗单位隔离病房收治住院的符合儿童2019-nCoV感染筛查/疑似病例129例,对其流行病学、发病特点、临床特征、实验室检查及转归、随访等进行总结分析。 结果 男 79例,女 50例,最小1个月,最大13岁,中位数2岁,51例(39.5%)有武汉疫区旅游或居住史,20例(15.5%)有与来自疫区有呼吸道症状人员接触史,17例(13.1%)周边或社区有确诊病例,3例(2.3%)有确诊病人接触史(其中2例为家庭确诊病例密切接触史),38例(29.5%)为临床符合或聚集性发病;临床症状:发热121例(93.8%),咳嗽92例(71.3%),流涕50例(38.8%),32例伴有腹泻、呕吐/腹痛(24.8%),102例(79.0%)白细胞降低或正常,C反应蛋白(C-reactive protein,CRP)<20 mg/L有103例(79.8%),57例(44.2%)胸片或CT示肺部斑片状影或实变;病原学检查:2019-nCoV实时荧光定量反转录PCR检测结果:所有患儿及陪同家属都有行咽拭子检查,只有21例患儿(16.3%)有行肛拭子检查,仅有1例(0.78%)家庭确诊病例密切接触者肛拭子阳性,但连续多次咽拭子结果阴性,余患者肛拭子和咽拭子及陪同家属咽拭子结果均阴性。其他病原学检查结果61例(47.3%),包括14例RSV阳性,9例流感病毒A,8例人偏肺病毒,6例肠道病毒,6例流感病毒B,6例肺炎支原体,4例副流感病毒1型,1例副流感病毒3型,2例人博卡病毒,3例腺病毒,1例肺炎克雷伯菌,1例人型葡萄球菌,其中1例合并副流感病毒1型及人博卡病毒。跟踪唯一1例确诊患者咽拭子多次检查均阴性,肛拭子持续19天后才转阴,一直无任何症状。其余患者好转出院后第3天、7天及14天进行随访,无异常发现。结论 儿童2019-nCoV感染筛查/疑似病例临床多表现为呼吸道或消化道症状,确诊主要依靠核酸检测,新冠病毒感染确诊率极低,而其将近50%病例能找到除新冠病毒外的其它相关病原体;高危患者为密切接触者,但存在漏诊的可能,肛拭子阳性率或高于咽拭子。
Objective To explore the epidemiological characteristics, onset characteristics, pathogenic mechanism of 2019-nCoV infection in children, and its control and prevention in Guangzhou. Methods From January 20, 2020 to February 29, 2020, a retrospective analysis was carried out on 129 suspected cases of 2019-nCoV infection admitted to the isolation ward of the only medical unit designated for children in Guangzhou. The epidemiology, disease characteristics, clinical characteristics, laboratory examination, outcome and follow-up were summarized and analyzed. Results There were 79 males and 50 females, with a minimum age of 1 month and a maximum age of 13 years. Anong them, 51 cases (39.5%) had a history of tourism or residence in the epidemic area of Wuhan, 20 cases (15.5%) had a history of contact with people with respiratory symptoms from the epidemic area, 17 cases (13.1%) with a confirmed case in the surrounding area or community, 3 cases (2.3%) had a history of contact with a confirmed patient (2 of them were family clustering cases), 38 cases (29.5%) were clinically suspected cases. Clinical symptoms: 121 cases with fever (93.8%), 92 cases with coughing (71.3%), 50 cases with runny nose (38.8%), 32 cases with diarrhea, vomiting or abdominal pain (24.8%). In 102 cases (79.0%), white blood cells were decreased or normal, 103 cases (79.8%) with CRP<20 mg/L, and 57 cases (44.2%) showed focal infection on chest X-ray or CT scan. Etiological examination: only one case (0.78%) of the family confirmed cases had positive anal swab result, but the throat swab results were negative all the time. The anal swab and throat swab results of other patients and the throat swab results of their accompanying family members were negative. Other pathogens were detected in 61 cases (47.3%), including 14 RSV positive cases, 9 influenza A positive cases, 8 human metapneumovirus positive cases, 6 enterovirus positive cases, 6 influenza B positive cases, 6 Mycoplasma pneumoniae positive cases, 4 parainfluenza virus type 1 positive cases, 1 parainfluenza virus type 3 positive cases, 2 human bocavirus positive cases, 3 adenovirus positive cases, 1 Klebsiella pneumoniae positive cases, 1 Human Staphylococcus positive case, and 1 case with parainfluenza virus type 1 and human bocavirus. The only confirmed patient was followed up while multiple pharyngeal swab results were negative, and the positive anal swab results lasted for 19 days before turning negative and remained asymptomatic. Other patients were followed up on the 3rd, 7th and 14th day after discharge, and no abnormal findings were found. Conclusion Screening/suspected cases of 2019-nCoV infection in children were mostly clinically manifested as respiratory or gastrointestinal symptoms. The diagnosis rate of nucleic acids was extremely low, and there was a possibility of missed diagnosis. Nearly 50% of cases could find other relevant pathogens excluding the 2019-nCoV. The positive rate of anal swab results was higher than that of pharyngeal swab.
目的 探讨雾化吸入干扰素-α治疗对儿童疱疹性咽峡炎的治疗效果的影响。方法 本研究纳入2019年1月—2021年1月在清远市妇幼保健院住院治疗的126例疱疹性咽峡炎儿童。所有参与该研究的患儿被随机平均分为2组:对照组(63人)和干预组(63人)。对照组进行常规治疗方案,干预组在对照组基础上雾化吸入干扰素-α治疗。比较2组治疗效果的差异性。结果 干预组患儿平均发热天数(1.86±0.97天)较对照组(2.44±0.89天)低;干预组心肌酶升高比例较对照组低,组间差异有统计学意义(P<0.01)。干预组中显效(50.8%)占主要比例,而对照组中有效(74.6%)占主要比例,并且干预组总有效率(98.4%)高于对照组(96.8%)(P<0.05)。干预组住院天数(5.02±1.85天)较对照组(5.68±1.68天)降低,组间差异有统计学意义(P<0.05)。结论 在常规治疗的基础上加用雾化吸入干扰素-α治疗对提高儿童疱疹性咽峡炎的疗效有促进作用,值得临床推广。
Objective To investigate the effect of nebulized inhalation of interferon-α on the therapeutic effect of herpes angina in children. Methods This study included 126 children with herpetic angina who were hospitalized in Maternal and Child Health Hospital of Qingyuan City from January 2019 to January 2021.All children participating in the study were randomly divided into 2 groups: control group (63 children) and intervention group (63 children). The control group received conventional treatment, and the intervention group was treated with aerosol inhalation of interferon-α on the basis of the control group.The difference of the treatment effect between the two groups were compared. Results The average number of fever days of children in the intervention group (1.86±0.97 days) was lower than that of the control group (2.44±0.89 days); the increase of myocardial enzymes in the intervention group was lower than that of the control group, and the difference was statistically significant (P<0.01). The “obviously effective” (50.8%) in the intervention group accounted for the main proportion, while the “effective” (74.6%) in the control group accounted for the main proportion, and the total effective rate of the intervention group (98.4%) was higher than that of the control group (96.8%,P< 0.05). The length of hospitalization in the intervention group (5.02±1.85 days) was smaller than that of the control group (5.68±1.68 days), and the difference was statistically significant (P<0.05). Conclusion The addition of nebulized interferon-α on the basis of conventional treatment could improve the curative effect of herpetic angina in children, and it is worthy of clinical promotion.
目的 使用金标免疫层析法检测儿童腹泻粪便标本,将其轮状病毒的结果进行分析汇总。方法 选取本院2020年1月—2021年1月收治的86例儿童腹泻者,根据金标免疫层析法的检测方式,将检测结果为阳性者的轮状病毒粪便标本进行回顾性分析。将86例阳性者的轮状病毒粪便标本送往我市疾控中心,采用逆转录-聚合酶链式反应(RT-PCR)进行检测,分析对比检测情况。结果 86例儿童腹泻感染经金标免疫检测为阳性者80例,阳性率为93.02%,同时将86例粪便标本送往本市疾控中心采用RT-PCR检测验证70例阳性,轮状病毒阳性率为81.39%,两种检测方法相比,金标免疫检测结果其准确度更高;80例阳性者中,1岁以下的婴幼儿为31例,占38.75%,较为多见,其次为1岁、2岁的儿童,各占23.75%、25.00%。季节性以秋季和冬季为轮状病毒的高发期,11-12月份36例,占45.00%,1-2月、9-10月18例、16例,占22.50%、20.00%;男女性别比中2组阳性率比较,经统计学分析无明显差异性(χ2=2.500,P>0.05)。结论 轮状病毒多以5岁以下的婴幼儿为主,秋冬季节较为常见,采取金标免疫层析法的检测方式,来检测儿童的粪便标本,其操作简单,可快速准确地检测出轮状病毒,且该方法具有一定的临床诊断价值,值得推广应用。
目的 检验家庭睡眠习惯调查(FISH)在评估孤独症谱系障碍(ASD)患儿睡眠评估中的信度和效度。方法 随机抽取在清远市妇幼保健院儿童语言行为科干预的199例2~6岁ASD共患睡眠障碍患儿,其照顾者同时完成FISH和儿童睡眠习惯问卷(CSHQ),2周后再次同时完成上述两个问卷,以检验FISH的信度和效度。结果 验证性因素分析的结果表明,五因素模型拟合良好(χ2=79.05,df=44,χ2/df=1.80, P<0.001,SRMR=0.06,GFI=0.94,IFI=0.89,RMSEA=0.06),总量表及各分量表有较高的内部一致性信度(0.71~0.77)和重测信度(0.79~0.88)。FISH的白天习惯分别与CSHQ的入睡延迟、夜醒呈负相关,入睡前习惯分别与CSHQ的睡眠抵触、睡眠焦虑、白天睡眠呈负相关,睡眠常规分别与CSHQ的睡眠抵触、入睡延迟、睡眠焦虑呈负相关,睡前父母行为分别与CSHQ的睡眠抵触、睡眠焦虑呈负相关,总分与CSHQ总分呈负相关,差异均有统计学意义(P<0.05)。结论 FISH具有较好的信度和效度,可作为ASD患儿睡眠习惯的评估工具。
Objective To test the reliability and validity of the famity inveritory of sleep habits(FISH) in the sleep assessment among children with autism spectrum disorder (ASD). Methods A random sample of 199 children with ASD and sleep disorders intervened in the Children's Language and Behavior Department of Maternal and Child Health Hospital of Qingyuan City were selected, their caregivers completed the FISH and the children's sleep habit questionnaire(CSHQ) at the same time, and completed the above two questionnaires again 2 weeks later to test the reliability and validity of the FISH. Results The results of confirmatory factor analysis showed that the five-factor model fits well (χ2=79.05, df=44, χ2/df=1.80, P<0.001, SRMR=0.06, GFI=0.94, IFI =0.89, RMSEA=0.06), the total scale and each subscale had high internal consistent reliability (0.71~0.77) and test-retest reliability (0.79~0.88). The daytime habits of FISH were negatively correlated with sleep delay and waking up at night of CSHQ respectively, the habits before sleep of FISH were negatively correlated with sleep conflict, sleep anxiety and daytime sleep of CSHQ respectively, the sleep routine of FISH was negatively correlated with sleep conflict, sleep delay and sleep anxiety of CSHQ respectively, the parents' behavior before sleep of FISH was negatively correlated with sleep conflict and sleep anxiety of CSHQ respectively, and the total score of FISH was negatively correlated with CSHQ, with statistically significant differences (P<0.05). Conclusions The FISH had good reliability and validity, and can be used as an assessment tool for children with ASD.