Clinical Analysis Of Necrotizing Pneumonia In Children

Objective: to analyze the clinical characteristics of necrotizing pneumonia and improve the level of early screening,diagnosis and treatment of clinicians.Methods: retrospective analysis of the children with community-acquired pneumonia hospitalized in the Department of respiratory infection from January 2016 to January2020,reevaluated the results of lung CT images,and selected 25 cases that met the diagnostic criteria of necrotizing pneumonia,except other diseases that often cause pulmonary cavitary lesions,analyzed the epidemiological characteristics,microbiological examination,laboratory examination results and clinical characteristics And analyze its characteristics.Results: there were 15 males(60%)and 10 females(40%);the age range was from July to 14 years(5.48 ± 3.54);24 Han(96%),1 Hui(4%);6 urban(24%),11 rural(44%),8 urban-rural(32%).One case was preterm,but it was of suitable age for growth and development.All 25 cases were previously healthy,without basic disease,congenital heart disease and congenital lung disease.Before the onset of the disease,they did not take immunosuppressant for a long time.It is more than that in winter,and there is a significant difference between seasons.Fever was found in 25 children,the length of stay was 9-57 days(20.96 ± 1.21);among them,high fever(96%),moderate and low fever(4%),the peak temperature before admission was 40 ℃(39.7 ℃ ～ 40.5 ℃),the mean heat range was 17 days(12-21.5 days),5 children(20%)with shiver,no children with super high fever;cough and expectoration were found in all children,2 children with panting(8%);8 children with chest pain(32%);4children with cough and expectoration Among the 25 children,23(92%)had positive signs of lung,10(30%)had symptoms of digestive tract,4(16%)had vomiting,9(36%)had abdominal pain,8(32%)had symptoms of headache,depression,drowsiness,etc;One patient(4%)had arthritis and 5(20%)had rash.The average length of stay was 20.96 ± 11.21 days(7-57 days).We found that there was a positive correlation between the length of stay and the neutrophil ratio of blood routine leukocytes(R: 0.464,P < 0.05).During the follow-up after discharge,we found that 4patients lost the follow-up,except for 1 patient who received surgical treatment,theother 10 cases of pulmonary necrosis were absorbed better,the fastest absorption was10 days after discharge,the latest one year,the median was 5 months(1-6 months).Conclusion: necrotizing pneumonia has a long course of heat,anti infection and hospitalization.Most of them are complicated with pleural effusion.Some of them need to be treated by thoracentesis and closed drainage.A few of them need surgical intervention.The overall prognosis is good.