| Pneumonia is one of the most common children's diseases in the world, According to the statistics of the World Health Organization (WHO), there are approximately 2 to 4 million children died from pneumonia each year; In the 20th century 70s, the Ministry of Health in the People's Republic of China included that pneumonia was the head of the four kinds of common children diseases. Lobar pneumonia is one of the common respiratory infectious pneumonia in childhood which is caused by various pathogens infection and is a acute lung inflammation, the lesions distribution can be lobar or segmental. In the past, the major pathogen of lobar pneumonia was streptococcus pneumoniae, young people have a high incidence rates, spitting rust sputum was the characteristic clinical feature of this disease, there was a large patchy or high density shadow or lung parenchyma infiltrates in the lung X ray or lung CT. but in the recent years, experts and scholars in domestic and foreign find that the number of lobar pneumonia of children is increasing and it is a multi-pathogen disease which is caused mixed or single by bacteria, mycoplasma, viruses or fungi, at the same time, because of the increasing types of pathogens, the clinical manifestations of lobar pneumonia is showing diversification, these changes make the diagnosis and treatment of lobar pneumonia more difficult in the clinical work,, so ,it is extremely important for the clinical workers to strengthen the understanding of lobar pneumonia and unhance the ability of diagnosis and treament.The objective of this article is to explore the characteristic of epidemiology and clinical features, pathogenic changes, treatment outcome, providing reference for the clinical workers, so as to pay close attention to lobar pneumonia, enhance the ability of diagnosis and treatment, and use the medicine reasonably for shortening the course of treatment and improving the prognosis.We studied 609 children with lobar pneumonia who were diagnosed and treated by the paediatrics department of the first hospital of Jilin university from 2005.1 to 2009.12.We ordered retrospectivly and make aggregate analysis of the datum of the onset year, season, gender composition, clinical symptoms, physical signs, the result of laboratory and radiation, clinical medicine and prognosis. All the collected clinical datum are compared and analysed with SPSS 13.0 statistical software by the Chi-square test and t,test, admitted the difference is statistically meaningful when P<0.05.Result: 1. The number of children lobar pneumonia in our hospital during the year 2005-2009 accounted for 5.91% among the number of children pneumonia in the same period, while the constituent ratio of different year was different, the constituent ratio of year 2008 was significant higher than the constituent ratio from year 2005 to 2007(P<0.05), the constituent ratio of year 2009 was a little less than the constituent ratio of year 2008, but the comparison of constituent ratio between year 2009 and year 2007 had no significant difference (P>0.05), the year 2008 was the highest-incidence year; 2. The constituent ratio of different season was different, the constituent ratio of winter was significantly higher than that of spring, summer and autumn (P<0.05), the comparison of constituent ratio between autumn and spring, summer had no significant difference (P>0.05), the constituent ratio between autumn , summer and winter has no significant difference (P>0.05), the constituent ratio of spring was significant higher than summer (P>0.05), the highest-incidence season was winter; 3. The datas we studied had 373 male cases and 236 female cases, the constituent ratio of different gender had significant difference (P<0.05), the constituent ratio of male (61.25%) was higher than the incidence rate of female (38.75%); 4. In the datas we studied, the constituent ratio of cases with ages above 7 years made up 67.00% and the constituent ratio of cases with ages below 7 years made up 33.00%, the former was higher than the latter, the constituent ratio of cases with ages between 7 years to 10 years was significant higher than other ages (P<0.05), from 2005 to 2009 , though the yearly constituent ratio of nurseling lobar pneumonia among the number of nurseling pneumonia increased year by year,,the comparison of constituent ratio of different year had no significant difference (P>0.05), the incidence rate of year 2009 was significant higher than the incidence rate of year 2005 and year 2006 (P>0.05); 5. The datas we studied included 485 fever cases, the number of cases with high fever (39℃~40℃) made up 41.86%, 556 cases had cough, but no case had rusty sputum which is typical and diagnosability for lobar pneumonia, 57.47% cases appeared lung rales after the first week of the course; 6. In the datas we studied, 342 cases had positive serum MP-IgM, the positive rate of 2009 was significant higher than other years; 7. The number of cases with high hs-CRP was 423, with density fluctuating between 30mg/L to 50mg/L which made up 47.99%; 8. In the result of body fluid culture, 269 cases had positive strains, among which the most bacterium was streptococcus which made up 21.19%, staphylococcus aureus made up 12.27% and klebsiella pneumoniae made up 10.78%; 9. In the lung imaging, the cases with pathological changes involved unilateral lung (73.24%) were more than bilateral lung (26.77%), left side (44.50%) were higher than right side (28.74%), cases with pathological changes involved right upper lung and left lower lung were the most common; 10. In the datas we studied,84.4% cases had complications, respiratory complications made up 43.00% , mainly presented as pleural effusion (53.85%), the injury of circulatory system, blood system and digestive system were major in the extrapulmonary complications; 11. 570 cases received systematic treatment, the average hospital stays was 17.47±5.06 days; there were 196 severe children, among them, 81 cases of heavier infection received the de-esdation therapy of antibiotics, other 115 cases received litre of order therapy, the average hospital stays of them was 15.49±4.13 days and 18.27±3.79 days, the comparison of them had significant difference (P<0.05); in the cases we studied, 62 cases were given the Chinese materia medica preparation-xuebijing on the base of conventional treatment, the average hospital stays of this cases was 15.16±4.91 days, it was significant higher than the average hospital stays (P<0.05); 122 cases were given BAL on the base of conventional treatment, the average hospital stays was 13.19±5.53 days, it was significant higher than the average hospital stays (P<0.05) ;in the cases we studied, 170 cases were cured, 386 cases got better, 14 cases died, 6 cases left permanent atelectasis till they accepted the follow-up, one atelectasis case lasted six months after discharge from hospital, other cases all had a good prognosis.Conclusions: 1. The highest-incidence season of children lobar pneumonia was winter; 2. The highest-incidence ages of children lobar pneumonia were 7 to 10 years ; 3. The different gender had different constituent ratio in children lobar pneumonia, male was higher than female; 4. In the etiology of lobar pneumonia ,the infection of mycoplasma was the most common, streptococcus pneumoniae was major in the children lobar pneumonia who were infected by bacterial; 5. While the definite etiology was not clear, macrolides sequential combining withβ-lactams treatment should be choice first;Creative point: 1. In the early stage of clinical, if the proof of etiology was lack,checking the hs-CRP in time will be propitious to the reasonable using of antibiotics, checking the hs-CRP dynamically can judge the effect of the medicine and the recovering; 2. Giving the de-esdation therapy to the severe case will reveive better effect than giving the litre of order therapy; 3. On the base of routine treatment, adding the Chinese herbs–xuebijing will be help to short the the duration; 4. At the same time of routine treatment, combining with BAL will advance the recovery of patient,s condition.
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