Analysis Of Clinical Characteristics Of 100 Children With Whooping Cough

Objective:To explore the clinical features of pertussis in children,aiming at guiding the diagnosis and treatment of pertussis in children.Methods:Retrospective analysis of clinical data of 100 children with pertussis hospitalized in the respiratory department of Jiangxi Children's Hospital from January 1,2016 to December 31,2018.The age,clinical manifestations,immunization status,hospitalization days,and images of the children were collected.The results of the examination,treatment results and other data were grouped according to different ages,immunization conditions,disease season,severity of illness,and whether other pathogen infections were combined,and clinical characteristics were analyzed.Results:1.There were 100 children,55 males and 45 females.The age ranged from January to 11 years,including 21 cases(21.0%)in the?3 month group and 79 cases(79.0%)in the>3 month group.In April 2018 and September 2017,the number was12 and 18 respectively.Compared with the three-year incidence trend,the number of whooping cough infections was the highest in 2017,accounting for 64.0%of the total number.2.Clinical manifestations:51 cases(51.0%)with spastic cough,49 cases(49.0%)with paroxysmal cough,35 cases(35.0%)with fever,30 cases(30.0%)with asthma;20 cases with facial cyanosis during cough(20.0%),12 cases(12.0%)with vomiting after cough,14 cases(14.0%)with hoarseness;8 cases(8/21,38.0%)of children in?3 months old group had cyanosis after color cyanosis,>The incidence of the3-month-old group(12/79,15.2%)was high,and the difference was statistically significant(P<0.05).3.Infection with pathogens:47 cases(47.0%)with simple pertussis infection and 53 cases(53%)with other pathogens.41(41/53,77.3%)children with whooping cough had a pathogen infection,10(10/53,18.8%)had two pathogen infections,and2(2/53,3.9%)had three pathogen infections..Among them,18(18/53,33.9%)were infected with cytomegalovirus,17(17/53,32.0%)were infected with respiratory syncytial virus,and 13(13/53,24.5%)were infected with parainfluenza virus.Seven patients(7/53,13.2%)were infected with Mycoplasma pneumoniae.There were significant differences in the number of hospital stays between the two groups(P<0.05).There was no significant difference in fever,asthma,vomiting after sputum,hoarseness,spastic cough,and total white blood cells(P>0.05).4.Vaccination:57 cases(57.0%)were not vaccinated with DTP,13 cases(13.0%)were not completed with D-vaccination,and 27 cases(27.0%)were completed.Unknown 3 cases(3.0%).The number of white blood cells and the number of hospital stays in the non-immune group were higher than those in the immunized group,and the difference was statistically significant(P<0.05).5.Blood routine:The total number of peripheral white blood cells is between(2.74~47.86)×10~9/L,with an average of 17.34×10~9/L.Of these,54(54.0%)had a total white blood cell count exceeding the normal range,39(39.0%)were normal,and 5(5.0%)were reduced.10 cases(10.0%)had a total white blood cell?20×10~9/L,6 cases(60.0%)had lymphocytosis(lymphocyte ratio?60%);3 cases(3.0%)had a total white blood cell>30×10~9/L,2 cases(66.7%)with lymphocytosis(lymphocyte ratio?60%).6.No obvious abnormalities were 17.0%,10.0%in both lungs,29.0%in bronchial pneumonia,24.0%in bronchitis,and 2.0%in pleural effusion,pleurisy2.0%,atelectasis 1.0%.7.13 cases(13.0%)improved fiberoptic bronchoscopy,all suggest endobronchial infection.8.88 cases(88.0%)were discharged from hospital,12 cases(12.0%)were discharged automatically,and there were no deaths;the hospital stay was 2 to 14 days,and the average hospitalization was 5.93 days.9.8 cases of severe cases,92 cases of the general group.The number of white blood cells and the number of hospital stays in the severe group were higher than those in the normal group,and the difference was statistically significant(P<0.05).Conclusion:1.Children with?3 months of age are more likely to have pertussis when coughing.2.Children with?3 months of age who are infected with whooping cough are more likely to have cyanosis when they are coughing than those at>3 months of age.3.Whooping cough combined with other pathogen infections is most common with cytomegalovirus,respiratory syncytial virus,parainfluenza virus infection,and will prolong hospital stay.4.The pertussis white blood cell count mostly due to the increase of lymphocyte count.The increase in peripheral blood leukocyte count was positively correlated with the severity of the disease.5.The imaging findings of pertussis lung have no obvious specificity.6.Children aged?3 months and who were not immunized with whooping cough were more likely to have leukopenia and hospitalization days after being infected with whooping cough than those in the immunized group.In the severe group,the total number of white blood cells and the number of hospital stays were higher than the normal group.