Retrospective Analysis Of 1121 Cases With Community Acquired Pneumoniain Children

Objective:This topic,through reviewing and analyzing the children withcommunityacquired pneumonia admitted to the Pediatrics Department of the Affiliated Hospital of North Sichuan Medical College in 2018,and analyzing their basic characteristics,clinical manifestations,auxiliary examinations,intervention methods,prognosisand outcomes,preliminarily understands the diagnosis and treatment level of CAP children in our hospital and the region,and provides data information and reference opinions for further improving the clinical management level of children with community-acquired pneumonia in our hospital and the region in the future.Methods:In this study,1121 children who met the diagnostic criteria for community acquired pneumonia were selected from January 1,2018 to December 31,2018 in the department of pediatrics of the affiliated hospital of North Sichuan Medical College,according to the age of the children,they were divided into infant group(29 days to 1 year old),young children group(1to 3 year old),preschool group(3 to 7 year old)and school-age group(7 to 14 year old).All the medical records collected were from the medical record room of our hospital and obtained the informed consent of the family members.The medical history and physical examination information of each group of children after admission were sorted out,the use of antibiotics and the results of various auxiliary examinations were recorded,including blood routine,liver and kidney function,myocardial enzyme spectrum,C-reactive protein,procalcitonin,joint examination of respiratory pathogens,sputum culture,chest film,etc.,and the living conditions of each group of children were counted Hospital days,treatment costs,prognosis and outcome.Results:1.Children's community-acquired pneumonia mainly occurs in infants and young children,with a male-to-female ratio of 1.36:1.The incidence rate of children in winter is higher than that in other group.2.Cough,tachypnea and fever are the most common clinical symptoms of community-acquired pneumonia in children.In addition,diarrhea and wheezing are also more common.There was no statistical difference in cough incidence among different age groups.The incidence oftachypnea in infants was significantly higher than that in older infants.The incidence of fever is correlated with age,and it is lower in infancy than in other age groups.The incidence of wheezing and diarrhea symptoms decreased with age.3.moist rales and wheezing sound are more common in auscultation of infants' lungs than in older infants.three depressions sign and flaring of alaenasi are more common in infants.The infection rate of bacteria in young children group and preschool group is higher than that in infant group and school-age group group.5.The number of children infected with influenza A and B virus and mycoplasma is more,and the infection rate of these three items in infant group is significantly lower than that in other three groups.6.The positive rate of sputum culture in the infant group was significantly higher than that in the other three groups.Haemophilus influenzae infection rate was the highest,followed by Streptococcus pneumoniae,Klebsiella pneumoniae and Escherichia coli.7.Azithromycin,amoxicillin and clavulanate potassium,cephalosporin three generations of antibiotics are used in children with CAP in our hospital.The usage rate of azithromycin increased with age.Antibiotic therapy was combined in all age groups.The combination rate of antibiotics was lowest in infant group and highest in school-age group.Conclusion:1.Youngage is an early warning factorforcommunityacquired pneumonia in children.2.Cough is the most basic symptom in children with CAP,but there is no specificity in the diagnosis of CAP.Tachypnea is an important indicator to evaluate the severity of CAP in children.At the same time,it has high sensitivity and specificity for the diagnosis of CAP.For young children,more attention should be paid to the respiratory frequency of children to avoid missed diagnosis and misdiagnosis.Fixed pulmonary moist rales are important signs for diagnosis of pneumonia.Pulmonary moist rales are more common in the early and middle stages of illness,and the younger the patient is,the more likely it is to appear rales.The incidence of lung wheezing sound in infants is higher than that in older infants,but wheezing sound cannot be used as a sign to judge the severity of pneumonia.three depressions sign and alar flap are more common in infancy,and the severity of the disease is higher than that of pulmonary moist rales.3.The bacterial infection rate in infant group and preschool group is higher than that in infant group and preschool group.Mycoplasma infection is mostly found in school-age children,but the problem of mixed mycoplasma infection in infancy still needs attention.The results of this study show that HI infection rate is higher than SP,and the reason needs to be confirmed by a large number of epidemiological studies.4.In this study,the usage rate of antibiotics in CAP children is as high as 100%,and the combination rate of antibiotics is much higher than that in other regions of our country.There is abuse of antibiotics in our hospital.At the same time,there is no clear pertinence in the selection of antibiotic types,which is an important point to be improved in the future.5.The average length of stay of children with community-acquired pneumonia in our hospital basically meets the requirements of clinical pathway management.