中国小儿急救医学最新文献

{"title":"Diagnosis and emergency treatment of bronchial foreign body by fiberoptic bronchoscopy","authors":"Xuan Xu","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.01.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.01.001","url":null,"abstract":"Tracheobronchial foreign body aspirations may cause cardiopulmonary arrest and sudden death.The incidence in children is higher than in adults.Rapid diagnosis and treatment are live saving.In this paper, we aimed to present our experience in tracheal foreign body aspirations by fiberoptic bronchoscopy. \u0000 \u0000Key words: \u0000Tracheobronchial foreign body aspirations; Children; Bronchoscopy","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"2-4"},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47922763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case report of congenital hyperinsulinemia with focal hyperplasia of the pancreas and literature review","authors":"Xiangwen Hu, S. Zeng, Yimin Zhu, Tian Yu, Bing Zhang, Tao Wang","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.01.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.01.015","url":null,"abstract":"目的 \u0000探讨先天性高胰岛素血症(CHI)患儿的临床特征、组织学分型，为儿科工作者提供诊断和治疗经验。 \u0000 \u0000 \u0000方法 \u0000回顾性分析我院收治的1例局灶增生型CHI患儿临床资料及预后，同时复习相关文献。 \u0000 \u0000 \u0000结果 \u0000患儿因反复低血糖、抽搐入院，我院诊断CHI，外院进一步18F-Dopa PET-CT及组织病理学检查，确诊为局灶增生型CHI。手术病灶切除治疗有效，随访血糖正常，但继发癫痫。 \u0000 \u0000 \u0000结论 \u0000CHI比较罕见，并且具有致死性及遗留神经系统后遗症，临床医生依据临床特征对高度怀疑CHI的患儿，应尽早完善18F-Dopa PET-CT检查，有助于早期确定CHI组织学分型，且能指导CHI的远期临床管理，减少神经系统损伤。","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"67-70"},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46986583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multicenter network assessment of three inflammation phenotypes in pediatric sepsis induced multiple organ failure","authors":"方伯梁, 钱素云","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.01.104","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.01.104","url":null,"abstract":"目的 \u0000成人脓毒症临床试验正在评估针对三种炎症表型的治疗方法，包括：(1)免疫麻痹相关；(2)血栓性微血管病变所致血小板减少相关；(3)序贯性肝衰竭相关。这三种表型尚无儿科多中心评估。本文假设这些表型与儿童脓毒症中巨噬细胞活化反应综合征发生率和病死率增加相关，并进行验证。 \u0000 \u0000 \u0000设计 \u0000前瞻性严重脓毒症队列研究。比较多脏器衰竭合并任一表型，多脏器衰竭无上述表型及单脏器衰竭患儿。 \u0000 \u0000 \u0000场所 \u0000Eunice Kennedy Shriver国立儿童健康和人类发展研究所儿科重症医学研究网络内的9家PICUs。 \u0000 \u0000 \u0000对象 \u0000留置动脉或中心静脉导管的严重脓毒症患儿。 \u0000 \u0000 \u0000干预措施 \u0000临床数据收集和每周两次血样本采集直至PICU入院第28天或离开PICU。 \u0000 \u0000 \u0000测量方法与主要结果 \u0000401例入选严重脓毒症病例中，112例(28%)单脏器衰竭(巨噬细胞活化反应综合征0%，0/112；病死率<1%，1/112)，289例(72%)多脏器衰竭(巨噬细胞活化反应综合征9%，24/289；病死率15%，43/289)。多脏器功能衰竭且合并表型患儿总体病死率较高(24/101比20/300；RR 3.56，95%CI 2.06－6.17)。与无炎症表型的188例多脏器功能衰竭患儿相比，合并表型的101例患儿巨噬细胞活化反应综合征发生率(19%比3%；RR 7.07，95%CI 2.72－18.38)和病死率(24%比10%；RR2.35，95%CI 1.35－4.08)均增加。 \u0000 \u0000 \u0000结论 \u0000这三种炎症表型与脓毒症所致多脏器功能衰竭儿童巨噬细胞活化反应综合征发生率和病死率增加有关。本研究为设计针对儿童炎症表型的多中心临床试验提供了推动和必要的基线数据。","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"77-77"},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47910286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three cases of phosphine poisoning misdiagnosed as fluoroacetamide poisoning and literature review","authors":"Yujuan Wang, Youpeng Jin, C. Zhao, Zhengyun Sun, Wei Wang","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.01.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.01.014","url":null,"abstract":"目的 \u0000探讨儿童磷化氢中毒的临床特点及诊疗，进一步减少该病的误诊、漏诊率及病死率。 \u0000 \u0000 \u0000方法 \u0000总结2018年我院小儿重症医学科收治的误诊为氟乙酰胺中毒的磷化氢中毒病例3例，对3例患儿的临床特点、治疗情况及预后进行总结分析。 \u0000 \u0000 \u0000结果 \u00003例患儿均以恶心、呕吐起病，以神经系统及心血管系统损害为主，误诊为氟乙酰胺中毒。后经详细追问病史，确诊为磷化氢中毒。经过血液净化、维生素C、甲泼尼龙、磷酸肌酸以及必要的呼吸循环支持等治疗后，2例痊愈出院，1例临床死亡。 \u0000 \u0000 \u0000结论 \u0000急性磷化氢中毒病死率高，对于婴幼儿，当家长提供磷化铝或磷化锌等毒物接触史或可疑接触史时，要注意是否发生磷化氢中毒，并尽早给予血液净化治疗，为救治患儿争取时间，改善预后。","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"64-66"},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44563724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative, intraoperative and postoperative nursing coordination of soft bronchoscope in pediatric intensive care unit","authors":"Xiaoli Shen, Xuan Xu","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.01.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.01.005","url":null,"abstract":"Primary and secondary airway problems directly affect mortality and disability in critically ill children in pediatric intensive care unit(PICU). Soft bronchoscope, as an important method for the diagnosis and interventional treatment of airway lesions in critically ill children in PICU, requires standardized seamless nursing cooperation throughout the whole process.This article discussed the nursing cooperation before, during and after soft bronchoscope operation in PICU. \u0000 \u0000Key words: \u0000Soft bronchoscope; Perioperative; Children; Nurse","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"18-20"},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46484091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bronchoscopy in the diagnosis and treatment of severe pneumonia in pediatric intensive care unit","authors":"Yun-gang Yang","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.01.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.01.002","url":null,"abstract":"Severe pneumonia is a common respiratory disease in pediatric intensive care unit(PICU). Airway lesions can be observed and specimens can be obtained by bronchoscopy to help to diagnose the cause and pathogen of severe pneumonia.For severe pneumonia, bronchoscopy interventional therapy is mainly used to relieve airway obstruction, remove necrosis material in the airway, and administer locally.In addition, bronchoscopy can guide tracheal intubation in the rescue of severe pneumonia.In conclusion, bronchoscopy is used in children with severe pneumonia in PICU, which can improve the diagnosis rate, improve the function of ventilation, and shorten the hospitalization time.It is worthy of clinical promotion and application. \u0000 \u0000Key words: \u0000Bronchoscopy; Severe pneumonia; Pediatrics; Interventional therapy","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"5-7"},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41808442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucocorticoid treatment of sepsis","authors":"Yun Cui, B. Ning, S. Zeng","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.01.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.01.006","url":null,"abstract":"","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"21-29"},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46144389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implement of flexible bronchoscopy in diagnosis and management of pediatric upper airway obstruction","authors":"Ying Zhao, Wei Xu","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.01.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.01.003","url":null,"abstract":"Acute upper airway obstruction is a very common urgent situation in pediatric emergency.It includes several types of disease, mostly classified as infectious and noninfectious.Children are dying with delayed diagnosis and airway clear.Except traditional techniques and rigid bronchoscopy, flexible bronchoscopy would be a very convenient and handable way in diagnosis and management of upper airway obstruction in children.Herence, we presented etiologies of upper airway obstruction and how could flexible bronchoscopy reveal and(or) manage them. \u0000 \u0000Key words: \u0000Children; Upper airway obstruction; Flexible bronchoscopy; Diagnosis; Management","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"8-13"},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46884253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nephrotic syndrome and atopic diseases in children","authors":"Yue-zhong Zheng, Xiuli Wang, L. Hou, Chengguang Zhao, Yang Yang, Yue Du","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.01.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.01.013","url":null,"abstract":"Nephrotic syndrome is a common glomerular disease in childhood and easy to recur.It has been found that children with nephrotic syndrome are often accompanied by atopic manifestations and there is high co-morbidity between nephrotic syndrome and atopic diseases.This article reviewed the pathogenesis, cytokines and treatment of nephrotic syndrome and atopic diseases in children to explore the similarity between them to provide new clues and methods for the treatment of nephrotic syndrome in children. \u0000 \u0000Key words: \u0000Children; Nephrotic syndrome; Atopic diseases; Similarity","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"59-63"},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49518124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological characteristics of acute paraquat poisoning in children in southwest Shandong and related factors of pulmonary interstitial fibrosis","authors":"Mengxiao Shen, Jinlong Liu, Lei Han, Xuemei Sun, S. Dong, Cheng-jun Liu, Baohai Shi, Hongfeng Zhu, Liping Chen, Tong Chen, Liwen Li, Bo Li, Zhaohua Zhang, Youpeng Jin","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.01.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.01.007","url":null,"abstract":"Objective \u0000To analyze the epidemiological characteristics of acute paraquat(PQ)poisoning in children in southwest Shandong, and the risk factors for pulmonary interstitial fibrosis. \u0000 \u0000 \u0000Methods \u0000This retrospective study was performed on the clinical data of children with acute PQ poisoning admitted from January 2013 to December 2017 in 12 hospitals in southwest Shandong.All participants were divided into pulmonary interstitial fibrosis group and no pulmonary interstitial fibrosis group on the basis of the chest CT 14 days after poisoning.The epidemiological characteristics and risk factors of pulmonary interstitial fibrosis were analyzed. \u0000 \u0000 \u0000Results \u0000During the study period, a total of 307 children with acute PQ poisoning were admitted to 12 hospitals, of which 61 (19.87%) were suffering from acute PQ poisoning.Forty-nine cases with complete clinical data were analyzed, including 26 male and 23 female patients poisoned by oral.The age distribution ranged from 8 months to 14 years.Poisoning mainly occured from July to September of each year.The mortality of acute PQ poisoning was 8.2%(4/49), and the incidence of pulmonary interstitial fibrosis in survival patients was 44.4%(20/45). Statistical differences (P<0.05) were found between the pulmonary interstitial fibrosis and no pulmonary interstitial fibrosis, with regard to the times of blood purification, the time from poison exposure to blood purification, the application rate of glucocorticoids, the concentration of PQ in urine, the pediatric critical illness score, the time from poison exposure to gastric lavage, the white blood count at admission, serum creatinine, arterial blood lactate, PaO2, PaCO2, and PaO2/FiO2; however, there was no significant difference in the proportion of blood purification treatment, the mode of blood purification treatment, alanine aminotransferase, aspartate aminotransferase, urea nitrogen, creatine kinase and troponin.Stepwise logistic regression analysis showed that the time from exposure to poison to gastric lavage(OR=0.683, 95%CI 0.210-2.222)and to blood purification(OR=0.0133, 95%CI 0.004-0.042), the times of blood purification(OR=2.862, 95%CI 1.450-5.648), concentration of PQ in urine(OR=1.435, 95%CI 1.085-1.898), and the use of glucocorticoids(OR=0.190, 95%CI 0.048-0.757) were the risk factors for pulmonary interstitial fibrosis(P<0.05). \u0000 \u0000 \u0000Conclusion \u0000Early gastric lavage and blood purification, increasing the frequence of adminitrating purification appropriately, using low-dose glucocorticoids can reduce the incidence of pulmonary interstitial fibrosis of children with acute PQ poisoning. \u0000 \u0000 \u0000Key words: \u0000Paraquat poisoning; Children; Blood purification; Pulmonary interstitial fibrosis; Glucocorticoids","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"30-34"},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48033636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}