摘要
目的探讨儿童急性呼吸道感染(ARI)致低氧血症的临床预测因素。方法选取2016年1月~2020年9月收治的3000例急性呼吸道感染患儿作为研究对象。观察所有患儿的临床症状和体征,并对病情进行诊断,分析急性呼吸道感染患儿低氧血症临床预测价值。结果55.9%(1677例)患有肺炎,34.5%(1035例)患有毛细支气管炎;血氧饱和度72%~100%,21.7%(650例)患儿诊断为低氧血症,其中46.2%(300例)为肺炎,33.7%(219例)为毛细支气管炎、13.7%(89例)为支气管炎、6.5%(42例)为上呼吸道感染;胸壁回缩是低氧血症最敏感的指标(敏感度90%),其次是中小湿啰音(敏感度87%)、鼻翼扇动(敏感度84%)、呼吸急促(敏感度81%)和无法进食(敏感度81%),而紫绀(阳性预测值88%)和鼻腔扩张(阳性预测值53%)是最好的预测指标;低氧血症评分为>24分的患儿敏感性、特异性和阳性预测值最高,其次是16~24分,随着分数逐级递减,敏感性、特异性和阳性预测值逐渐降低。结论胸壁回缩、紫绀联合低氧血症评分对ARI患儿低氧血症具有预测价值,而且能够检测患儿是否需要氧气治疗。
Objective To determine the clinical predictors of hypoxemia in children with acute respiratory infection(ARI).Methods 3,000 children with acute respiratory infections admitted to the pediatric of our hospital from January 2016 to September 2020 were selected as the research objects.Observe the clinical symptoms and signs of all patients,diagnose the condition,and analyze the clinical predictive value of hypoxemia in children with acute respiratory infection.Results 55.9%(1,677 cases)had pneumonia,34.5%(1,035 cases)had bronchiolitis.The blood oxygen saturation was between 72%and 100%,21.7%(650 cases)of children were diagnosed with hypoxemia,of which 46.2%(300 cases)were pneumonia,33.7%(219 cases)were bronchiolitis,13.7%.Chest wall retraction was the most sensitive index of hypoxemia(sensitivity=90%),followed by medium and small wet rales(sensitivity=87%),alar movement(sensitivity=84%),shortness of breath(sensitivity=81%)and inability to eat(sensitivity=81%),while cyanosis(positive predictive value=88%)and nasal dilatation(positive).The predictive value=53%)was the best predictor.Children with a hypoxemia score>24 points have the highest sensitivity,specificity,and positive predictive value,followed by 16~24 points.As the score decreases,the sensitivity,specificity and positive predictive value gradually decrease.Conclusion Chest wall retraction,cyanosis and hypoxemia scores have predictive value for hypoxemia in children with ARI,and can detect whether children need oxygen therapy.
作者
马如青
MA Ru-qing(Department of Pediatrics,The People’s Hospital of Xingbin District,Laibin 546100,China.)
出处
《中国处方药》
2021年第2期11-13,共3页
Journal of China Prescription Drug
关键词
急性呼吸道感染
儿科急诊
低氧血症
预测因素
Acute respiratory tract infection
Pediatric emergency
Hypoxemia
Predictive factors
