目的:探讨新生儿甲型流行性感冒的临床特点、治疗及预后.方法:回顾分析2018年1月至2020年1月湖南省儿童医院新生儿科收治的诊断为甲型流行性感冒的25例住院新生儿临床资料,对患儿的临床特点、辅助检查、治疗过程及疾病转归进行分析.结果:25例患儿中,男17例,女8例.16例足月儿,9例早产儿,其中7例为晚期早产儿.18例冬春季发病,7例夏季发病.12例发病前有"感冒"症状家人密切接触史.临床表现咳嗽17例,发热17例,呼吸困难10例,鼻塞12例,流涕3例,呼 吸暂停1例.25例患儿甲型流感病毒抗原检测均为阳性,6例患儿同时呼吸道合胞病毒检测阳性,17例痰细菌培养阳性.16例使用奥司他韦治疗,2例使用帕拉米韦治疗.24例治愈出院,1例死亡,死亡患儿为早产儿.结论:新生儿甲型流感症状多不典型,冬季和夏季发病多见,预后大多较好,但早产儿需警惕严重并发症及不良预后.

目的 探讨降温贴预防儿童大剂量甲氨蝶呤化疗所致口腔黏膜炎的疗效.方法 将102例接受大剂量甲氨蝶呤化疗的急性淋巴细胞白血病患儿随机分为对照组和观察组各51例.对照组采用常规口腔护理,观察组在此基础上采用降温贴冷敷患儿两侧颊部1周.结果 干预后,观察组口腔pH值显著高于对照组,口腔黏膜炎发生率显著低于对照组、口腔黏膜炎分级显著轻于对照组,且口腔疼痛评分显著低于对照组(均P＜0.05).结论 降温贴冷敷有利于改善口腔内pH值,有效预防化疗性口腔黏膜炎,减轻口腔黏膜炎严重程度及口腔疼痛.

Objective:To analyze the clinical characteristics of 86 neonates with enterovirus infection.Methods:A retrospective analysis was performed in neonates with enterovirus infection in Neonatology Department at our hospital from May 2019 to July 2019.Clinical characteristics and laboratory examinations of the neonates were collected and analyzed.Results:There were 86 cases of neonatal enterovirus infection, including 59 males and 27 females; 75 full-term infants and 11 premature infants; 17 early-onset neonates and 69 late-onset neonates; 82 cases were cured and discharged, and four cases died.The first clinic symptoms included fever (75/86, 87.2%), jaundice (50/86, 58.5%), dyspnea (17/86, 19.8%), rash (9/86, 10.5%), diarrhea (9/86, 10.5%), abdominal distension (8/86, 9.3%), vomiting (5/86, 5.8%), and convulsion (2/86, 2.3%). Coagulation dysfunction (17/86, 19.8%), liver dysfunction (11/86, 12.8%), and myocardial damage (9/86, 10.5%) were founded in severe cases.Six infants had hepatic necrosis with coagulopathy (HNC), and four of them died.Compared with control group, earlier age of onset(<7 days), dyspnea, abdominal distention, coagulation dysfunction, liver function damage, myocardial damage, hypoproteinemia, procalcitonin increased, decreased platelets and death rate were significantly higher than those in infants from HNC group ( P<0.05). Conclusion:Neonatal enterovirus infection have diverse manifestations.Infants with HNC have high mortality and are needed to be monitored closely.

Acute poisoning is usually an emergency,the acute poisoning of children is more prominent,Its death threat is greater than that of adults.Although the conventional treatment of acute poisoning is crucial,such as vomiting,gastric lavage,catharsis and diuresis,but for children with severe acute poisoning,simply using conventional treatment methods are often difficult to support the children through the dangerous period.In recent years,the application of blood purification therapy has saved more and more children with critically acute poisoning.Because of the variety of poisons,the complexity of toxicological mechanisms and the different clinical manifestations,emergency pediatricians mainly depend on the types of poisons and clinical experience to determine whether blood purification should be carried out in children with acute poisoning and what kind of blood purification mode should be chosen.There are almost no relevant guidelines for reference.Timing of blood purification therapy and reasonable mode selection are particularly important.