| Objective:To further understand the clinical characteristics of children with pertussis and analyze the risk factors for severe pertussis,to enhance the further awareness of the disease,and to provides a certain clinical basis for pediatricians to conduct early diagnosis and standardized treatment of pertussis in children.Methods:Using a retrospective analysis method,refer to the medical records of 151patients with pertussis hospitalized in the respiratory department and(or)infection department of Guiyang Maternal and Child Health Hospital from January 01,2018 to December 31,2021.Collected general data(gender,age,epidemiological history,immunization status),course of disease,clinical symptoms and signs,complications,auxiliary examination,treatment and prognosis and other clinical data。Grouped by age,immunization status,disease severity,and whether combined with other pathogen infection,the summary and clinical characteristics were analyzed respectively。All the data were collated and analyzed using Excel and SPSS 22.0 software.Results:1.General situation:A total of 151 cases,87 in male cases,64 in female cases,88 in urban cases and 63 in rural areas.They were between 1 month of age to 4 years and 7 months,including 113 children at<6 months.From 2018 to 2021,there were10,95,5 and 41 cases,respectively,accounting for 62.91%of the total number in2019.All year,mostly in spring and summer.Non-vaccinated individuals accounted for 64.24%,failure to complete the whole immunization accounted for 12.58%.A history of cough exposure was noted in 38.4%of the patients.2.Clinical manifestations and complications:There were 146 cases of paroxysmal cross cough,138 cases of spastic cough,and only 5 cases of chicken crow sample end.There were109 cases with bronchopneumonia and 13 cases with severe pneumonia.3.Blood routine:The mean peripheral blood leukocytes was(16.68±8.05)×10~9/L,69.54%accounted for≥12×10~9/Land 23.84%for≥20×10~9/L的.Lymph ratio of≥0.6accounted for 80.13%.4.Combined pathogen infection:45 cases had positive sputum culture,mostly streptococcus pneumoniae.Respiratory seven virus antigen was positive for 18 cases,and respiratory syncytial virus was the most common.8 cases were complicated with Mycoplasma pneumoniae infection.There was no significant difference between the pure and mixed groups in hospital days,course length,and disease severity.5.Chest imaging:7 cases were normal,73 cases were bronchopneumonia,69 cases were bronchitis,4 cases were pulmonary consolidation,One patient was with atelectasis,pleural thickening and pneumothorax.The rate of bronchopneumonia was the highest.6.Treatment:There were 149 cases using macrolides against infection,the mean treatment course was(1.10±0.44).Associated with bacterial infections,combined cephalosporins were used in 83 cases,penicillin class occurred in 11 cases,carbogenenenes in 6 cases,2 cases of glycopeptides and oxazolidinones.7.Hospital days of 3 to 44 days,average of(10.93±4.95)days,the mean total disease course was(25.56±9.52)days.141 Patients were effective,ineffective in 2 cases;no deaths.8.The incidence of vomiting after cough gradually increases gradually with age,and the percentage of peripheral blood lymphocytes decreased progressively with increasing age,the difference was statistical significance(P<0.05).The incidence of cyanosis with severe cough at<6 months was higher than the group above 6 months,the difference was statistical significance(P<0.05).9.In the severe group,the incidence of three concave sign,pulmonary consolidation/atelectasis were higher than in the general group,the difference was statistically significant(P<0.05).Elevated WBC count is an independent risk factor for the development of severe pertussis(P<0.05).Conclusion:1.Infants<6 months of age and without pertussis vaccine have a highsusceptibility and incidence of pertussis.2.Pertussis has a mostly good prognosis.3.Pertussis occurs throughout the year and occurs more frequently in spring and summer.4.The clinical manifestations of pertussis are diverse,mainly paroxysmal cross cough and spastic cough.5.Pertussis complications are most frequently seen by bronchial pneumonia.6.The total number of leukocytes in the peripheral blood was mostly increased,mainly with the lymphocyte count increased,and elevated white blood cell count is a risk factor for the development of severe pertussis.7.Pertussis infection with other pathogens is common by respiratory syncytial virus and Streptococcus pneumoniae. |
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