重庆地区6岁以内儿童反复下呼吸道感染的病因分析

Etiological factors of recurrent lower respiratory tract infection in children under six years old in Chongqing

摘要:

目的：分析重庆地区6岁以内儿童反复下呼吸道感染的可能病因，为儿科医师提供一定的诊疗思路。方法：回顾性分析2015年6月至2019年5月于重庆医科大学附属儿童医院呼吸中心住院治疗的反复下呼吸道感染的417例重庆籍儿童病例资料。根据年龄分为1岁内（197例），1~3岁（129例），3~6岁（91例）3组，分析3组儿童住院期间的检查结果及诊疗经过。结果：分析发现，1岁内：营养不良（中~重度）17例，胃食管反流30例，气管食管瘘9例，气管环7例，支气管软化（中-重度）11例，肺动脉吊带6例，先天性心脏病70例，先天性肺囊肿3例，不明原因44例。1~3岁：咳嗽变异性哮喘12例，支气管哮喘41例，原发性免疫缺陷病5例，先天性心脏病19例，先天性肺囊肿5例，支气管异物7例，闭塞性细支气管炎3例，先天性腺瘤样畸形2例，原发性纤毛运动障碍5例，支气管扩张11例，不明原因19例。3~6岁：咳嗽变异性哮喘21例，支气管哮喘37例，原发性免疫缺陷病5例，支气管扩张12例，支气管异物2例，先天性肺囊肿1例，颅内占位1例，不明原因12例。结论：重庆地区6岁内儿童反复下呼吸道感染主要病因与年龄密切相关，1岁以内与先天发育异常关系密切，1岁以上主要原因与哮喘相关。

Abstract:

Objective：To analyze the etiological factor of recurrent lower respiratory tract infection（RLRTI） in children under six years old in Chongqing，so as to provide pediatricians references for diagnosis and treatment. Methods：Clinical data of 417 children under six years old in Chongqing with recurrent RLRTI hospitalized in the respiratory ward of Children’s Hospital of Chongqing Medical University from June 2015 to May 2019 were collected and analyzed retrospectively. The 417 patients were divided into three groups according to ages：the < 1 year old group（197 patients），the 1-3 years old group（129 patients） and the < 6 years old group（91 patients）. Examination results and treating ways in three groups were analyzed. Results：According to results，children < 1 year old had malnutrition（moderate to severe） of 17 cases，gastroesophageal reflux of 30 cases，tracheoesophageal fistula of 9 cases，tracheal ring of 7 cases（3.55%），bronchial softening（moderate to severe） of 11 cases，pulmonary artery sling of 6 cases，congenital heart disease of 70 cases，congenital pulmonary cyst（CPC） of 3 cases and unclear etiology factors of 44 cases. Children between 1-3 years old had cough variant asthma（CVA） of 12 cases，bronchial asthma of 41 cases，primary immunodeficiency disease（PID） of 5 cases，congenital heart disease of 19 cases，congenital pulmonary cyst of 5 cases，bronchial foreign body of 7 cases，occlusive bronchi－olitis of 3 cases，congenital adenomatoid malformation of 2 cas－es，primary ciliary dyskinesia of 5 cases，bronchiectasis of 11 cases and unclear etiology factors of 19 cases. Children between 3-6 years old had CVA of 21 cases，asthma of 37 cases，PID of 5 cases，bronchiectasis of 12 cases，bronchial foreign body of 2 cases，CPC of 1 case，intracranial space-occupying diseases of 1 case and unclear etiology factors of 12 cases. Conclusion：Etiological factors of RLRTI in children under six years old in Chongqing are closely related to age. Patients less than one year old are closely related with congenital dysplasia，while patients over one year old are closely related with asthma.