Abstract
目的 探讨儿童危重症2009甲型H1N1流感呼吸系统并发症的临床及影像学特点.方法 回顾性分析31例危重症2009甲型H1N1流感患儿的呼吸系统并发症的临床及影像学资料.结果 31例中,男27例(87.1%),年龄中位数5岁,以发热、咳嗽起病,可伴呕吐、抽搐、昏迷等症状,5例死亡.影像学检查均有肺炎表现,其中双肺野中内带多发斑片状模糊影、实变影28例(90.3%),伴磨玻璃样密度影12例(38.7%),多位于外周胸膜下.在初次检查时伴有肺段/叶实变15例(48.4%),可见支气管充气征,伴或不伴节段性肺不张;复查时增至21例(67.7%).在初次检查时伴有胸腔积液7例(22.6%),随访增至12例(38.7%).在初次检查时伴有气胸及纵隔气肿6例(19.3%),随访增至8例(25.8%).结论 儿童危重症2009甲型H1N1流感可出现严重的呼吸系统并发症,影像学特点为双肺多发斑片状模糊影、实变影,伴磨玻璃样密度影;胸腔积液、气胸及纵隔气肿的发生率高;呼吸系统并发症多数愈后良好。
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