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Hospital Acquired Infections at the Service of Pediatric Surgery in Gabriel TouréAcademic Hospital, Bamako, Mali 认领
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作者 Y. Coulibaly O. Kone +9 位作者 I. Amadou T. H. M. Diop O. Coulibaly A. Doumbia B. Kamaté H. Ouologuem D. Konaté M. Coulibaly B. Maiga M. I. Mangané 《儿科学期刊(英文)》 2020年第1期185-193,共9页
Introduction:?Health care-associated infection is an infection acquired during the care delivered in the hospital or in any other care establishment which was neither present, nor in incubation at the admission of the... Introduction:?Health care-associated infection is an infection acquired during the care delivered in the hospital or in any other care establishment which was neither present, nor in incubation at the admission of the patient or at the time of delivering the care or which does not manifest itself only after the patient has been discharged or an infection contracted by the professional in the course of his duties. Objectives:?To identify mean causative germs?and to determine their sensitivity to antibiotics and to identify the risk factors of?health care-associated infection.?Material and methods:?It was about a prospective longitudinal study conducted from November 1, 2017 to April 1, 2018?(6 months) in all children admitted to the pediatric surgery service. Non-consenting parents and outpatient necrosectomy case have not been included in this study.?Results:?This study included 200 patients, of whom 30 experienced the hospital acquired infections with an infection rate of 15%. The surgical site infection was the most common type, with 16 cases (53.3%), followed by burns in 13 cases (43.3%) and urinary tract infection in 1 case (3.3%). The average age of patients with infection was 56.33 ± 48.66 months with extremes of 1 and 180 months. The sex ratio was 1.30 for infected patients and was 1.83 for uninfected patients. The main bacteria responsible for surgical site infection were: Escherichia coli?(4 cases), Acinetobacter baumanii?(3 cases), Klebsiella pneumoniae?(2 cases), Staphylococcus aureus?(2 cases), Enterobacter cloacae?(1 case), Pseudomonas aeruginosa (1 case) and Enterobacter faecalis?(1 case). Among burn patients, the most frequent germs were: Acinetobacter baumanii?(7 cases), Klebsiella pneumoniae?(6 cases), Staphylococcus aureus?(6 cases), Escherichia coli?(4 cases), Pseudomonas aeruginosa?(2 cases) and Enterobacter faecalis?(2 cases). Escherichia coli?was?noted only in the case of urinary tract infection. Antibiotics tested were: amoxicillin, amoxicillin associated with clavulanic acid, ceftriaxone, 展开更多
关键词 Infection GERMS SENSITIVITIES Risk Factors Child MALI
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Growth and Associated Factors in Children and Adolescents Living with HIV/AIDS Followed at the Mother and Child Centre of the Chantal Biya Foundation, Yaoundé-Cameroon: A Case Control Study 认领
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作者 David Chelo Eulalie Landrine Moguon Fondjo +4 位作者 Pierre Fotsing Kwetche Séraphin Nguefack Félicitée Nguefack Suzanne Ngo Um Georges Nguefack Tsague 《儿科学期刊(英文)》 2020年第1期194-205,共12页
Background: HIV/AIDS has a negative impact on child growth. Assessing the growth of infected children is an important part of the overall care of these children which in turn improves the monitoring and prognosis of t... Background: HIV/AIDS has a negative impact on child growth. Assessing the growth of infected children is an important part of the overall care of these children which in turn improves the monitoring and prognosis of the disease. The purpose of the study was to describe and compare the growth of children living with HIV with those not infected and to identify the associated factors. Method: This was an analytical case control study conducted in a pediatric hospital, Yaoundé from January 25th to June 20th 2019. Our study population consisted of 164 children with an age range from 06 weeks to 19 years old of which we had 41 HIV-infected cases and 123 uninfected controls matched by sex and age plus or minus 02 months. Anthropometric parameters were measured according to the standards described by the WHO. The data was entered and analyzed using Epi info 3.5.4, WHO Anthro and WHO Anthropoplus softwares. The chi-square and the Fisher’s exact tests were used to compare qualitative variables, with a significance threshold set at P less than 5%. Results: Of the 41 cases, 15 (36.6%) had at least one anthropometric index (weight for age, height for age, weight for height) -2 Z score versus 05 for controls (4.1%). 36.6% of cases had growth retardation (Height for age -2 Z score) compared to 4.1% in controls with a significant difference (p = 0.000). In 18.2% of cases, underweight was found (Weight for age -2 Z score) with a significant difference compared to controls (p = 0.000). Wasting was present in 10% of infected children (P = 0.240). We found 7.3% obesity/overweight in cases and 25.2% in controls (P = 0.003). We did not find any associated factor with growth disorders in our study. Conclusion: Infected children are smaller in weight and size. After multivariate analysis, there remained a significant difference between cases and controls regarding stunting, obesity and overweight. No factors studied were associated with the growth disorders detected, which suggests that growth disorders in children and adolescents li 展开更多
关键词 GROWTH HIV/AIDS CHILD ADOLESCENT Yaoundé
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Surgical Complications of Pica Syndrome: About 03 Cases 认领
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作者 A. Doumbia Y. Coulibaly +10 位作者 I. Amadou M. Keita O. Coulibaly B. Kamaté M. K. Djiré M. Y. Coulibaly S. Camara H. Diall B. Maiga D. Konaté K. Sacko 《儿科学期刊(英文)》 2020年第1期159-167,共9页
The Pica syndrome is an eating disorder characterized by an excessive or abnormal desire to consume a non-nourishing substance which can be relatively harmless, or potentially harmful for the health. It is a rare affe... The Pica syndrome is an eating disorder characterized by an excessive or abnormal desire to consume a non-nourishing substance which can be relatively harmless, or potentially harmful for the health. It is a rare affection secondary to the accumulation of diverse nature foreign bodies inside the digestive tract and more especially at the stomach level. Gastro-intestinal localization is the most frequent, and can remain long time asymptomatic. Treatment is surgical. We report 3 cases of digestive complication of Pica syndrome. The first one was operated for gastric perforation due to nail (53 nails, a pin and bands of tape recorder cassette ingested), the second one for trichobezoar and the last had a subocclusion by pieces of granite. 展开更多
关键词 PICA SYNDROME COMPLICATIONS BEZOAR CHILD MALI
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Prospective Study of Domestic Accidents of the Child in Brazzaville, Congo 认领
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作者 Kambourou Judica?l Moyen-Engoba   +5 位作者 Oko Aymar Pierre Gildas Lombet Leticia Diall Boubakar Massamba Alphonse Moyen Georges 《儿科学期刊(英文)》 2020年第1期175-184,共10页
Background:?Home related accidents have emerged as an important public health issue in pediatrics. However, very few studies have been conducted in sub-saharan countries on domestic accidents among children. The purpo... Background:?Home related accidents have emerged as an important public health issue in pediatrics. However, very few studies have been conducted in sub-saharan countries on domestic accidents among children. The purpose of this study was to determine the hospital frequency of domestic accidents in Brazzaville children, the type of accident, establish etiological factors and mortality.?Methods:?A total of 173 cases of domestic accidents were collected through a prospective study conducted from 1 January to 31 December 2017 in the pediatric intensive care unit of the University Hospital of Brazzaville. Medical records of children victims of unintentional trauma at home or in its immediate surroundings were collected. The following variables were recorded: the age and sex of the child, the hour, day and month of occurrence of the accident, parental attitudes in the management, and the prognosis (mortality).?Results:?Domestic accidents accounted for 9.2% of all admissions. The average age was 28.8 ± 10.5 months, a male predominance was noted (sex ratio equal to 1.6). Domestic accidents were found in 57.5% of children under two years (p??0.05). These children belong with more than 3 children in 63% of the cases. Accidents were dominated by ingestions (56.1% of cases), followed by falls (16.2%), burns (10.9%) and drug poisoning (9.2%). They often occurred between 12?pm and 8?pm, most often in the yard, the kitchen and the surroundings of the home. Three cases of death (1.53%) were enrolled including 2 cases of burns.?Conclusion:?domestic accidents are common in Brazzaville but their frequency is underestimated. Accidental ingestion remains the most frequent type of accident and mortality is high. Control of the causative factors is necessary to undertake effective preventive actions. 展开更多
关键词 DOMESTIC Accidents BURN Fall CHILD INTOXICATION
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<i>Helicobacter pylori</i>Infection (<i>Hp</i>) among Children in the Northern Benin in 2018 认领
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作者 J. Agossou K. Alassan Saké +5 位作者 F. Mohamed Agbeille A. Noudamadjo S. Gasso M. G. Kpanidja J. D. Adédémy Z. R. Ahodègnon 《儿科学期刊(英文)》 2020年第1期75-84,共10页
Background: Hp infection is the most common chronic bacterial infection in developing countries and is contracted especially in childhood where it remains silent. Because of its involvement in the genesis of certain c... Background: Hp infection is the most common chronic bacterial infection in developing countries and is contracted especially in childhood where it remains silent. Because of its involvement in the genesis of certain cancers, the WHO has classified Hp in the category of carcinogen class I. The aim of this study was to determine the prevalence of Hp infection among children from a District in Northern Benin, and to identify the factors associated with it. Patients and methods: This scientific investigation is a cross-sectional, descriptive, and analytical study based on a prospective collection of data carried out from July to September 2018. Recruitment was probabilistic;it was based on the WHO cluster sampling technique implemented among children aged 3 to 10 years without recent history of antibiotic treatment and proton pump inhibitors. Hp infection was diagnosed during the search for bacteria antigen in the feces through a quick Elisa test which proved positive. Results: We included 250 children in the study. Among them, 151 (60.4%) had Hp infection. 79 (52.3%) out of the 151 infected children were female, i.e. a sex ratio of 0.91. Mean age for those infected children was 6 ± 2.3 years. Among the 151 children infected with Hp, 98 (64.9%) were asymptomatic. Factors associated with that infection were: children’s age > 5 years (p = 0.0461), use of contaminated drinking water (p = 0.0001), meals away from home (p = 0.0039), mothers’ low educational status (p = 0.0137) and low monthly income (p = 0.0116) as well as household size > 3 (p = 0.0002). Conclusion: Hp infection is common among children aged 3 to 10 years in Northern Benin. Often asymptomatic, it is facilitated and exacerbated by unsanitary conditions and low socioeconomic status. 展开更多
关键词 HELICOBACTER PYLORI Child Northern BENIN
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Kaposi’s Disease (KS) in a Senegalese Child Living with HIV 认领
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作者 F. Ly B. Niang +8 位作者 Y. Keita C. Dial A. Sow A. Sakho Kane B. S. Ndiaye A. Sylla B. Camara A. Ly Ba O. Ndiaye 《儿科学期刊(英文)》 2020年第1期85-93,共9页
Kaposi’s Disease or Kaposi’s Sarcoma (SK ) is a multifocal malignant proliferation induced by viral growth factors, including interleukin 6 of human herpes virus type 8 (HHV8). We describe four forms of this disease... Kaposi’s Disease or Kaposi’s Sarcoma (SK ) is a multifocal malignant proliferation induced by viral growth factors, including interleukin 6 of human herpes virus type 8 (HHV8). We describe four forms of this disease who poses a real public health problem in East and Central Africa. The purpose of our observation was to report a rare condition in a Senegalese HIV-positive child. It was an 11-year-old girl from a region in central Senegal. She was an orphan of both parents, tested and monitored since the age of 5 for HIV infection 1. She was on the 1st line protocol. Due to a lack of support and good observance, she was referred to us at the age of 11 for follow-up in our structure in the suburbs of Dakar. The initial follow-up assessment showed a very low CD4 count and a very high viral load. Before the lack of clinical and immune-virological response, a genotypic resistance test was performed and showed immunological and virological failure. The initial development was marked by the appearance of lesions which were highly suggestive of Kaposi’s disease. She was on 2nd line treatment. The histopathological aspect of cutaneous biopsy was very suggestive of Kaposi’s disease. The subsequent course after ART and bleomycin treatment was clinically marked by regression of skin lesions. Virologically, it was marked by a fall in the viral load. Immunologically there was a gradual recovery of CD4 levels which came back to normal. Our observation demonstrates that absence of effective antiretroviral therapy for HIV increases the risk to develop Kaposi’s sarcoma. 展开更多
关键词 Kaposi’s SARCOMA ANTIRETROVIRAL Therapy HIV CHILD
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Profile and Antibiotic Sensitivity of Acute Pyelonephritis in Children at Gabriel Toure Teaching Hospital, Bamako 认领
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作者 Djénèba Konaté Lala N’Driany Sidibé +25 位作者 Karamoko Sacko Bakary Koné Adama Koné Aminata Doumbia Fatoumata Tiero Pierre Togo Fatouamata Léonie Diakité Abdoul Karim Doumbia Belco Maiga Fousseyni Traoré Aamadou Touré Hawa Diall Mohamed Elmouhouloud Cissé Adama Dembélé Oumar Coulibaly Yacouba Aba Coulibaly H. Konaré Isabelle Traoré Guédiouma Dembélé Issiaka Koné Leyla Ma?ga Ibrahima Ahamadou Abdoul Aziz Diakité Boubacar Togo Mariam Sylla Fatoumata Dicko-Traoré 《儿科学期刊(英文)》 2020年第1期94-108,共15页
Background: Very common symptom in children, fever, perhaps a warning sign of more or less severe pathology, rapidly progressive, including an invasive bacterial infection such as acute pyelonephritis (APN). The aim o... Background: Very common symptom in children, fever, perhaps a warning sign of more or less severe pathology, rapidly progressive, including an invasive bacterial infection such as acute pyelonephritis (APN). The aim of this work was to study the bacteriological profile and antibiotic sensitivity of APN in children. Methods: A prospective study involving any infant or child aged 3 months to 15 years with an acute fever (≥38°C) in which a urine test strip was performed in the pediatric department of the teaching hospital Gabriel Toure between April 1st and May 15th, 2019 (45 days). Results: 124 children were included out of 244 febrile patients. Infants (3 - 23 months) predominated (52.8%) with a sex ratio of 2. Seventy-five percent of children came directly from home and 30.6% were on antibiotic prior to admission. The urine bag sample was taken in 55.6% and the urine was macroscopically cloudy in 32.3%. Stigmas of urinary tract infection at the urinary strip were present in 56.5%. Confirmation of acute pyelonephritis (APN) by CytoBacteriological Urine Examination (CBUE) was 29% with Escherichia coli (63.9%) or Enterococcus faecalis (30.5%). Sensitivity was excellent for ciprofloxacin and imipenem (100%). The overall resistance was greater for gentamicin, cotrimoxazole, ceftriaxone, cefotaxime and amoxicillin-clavulanic acid (Threshold: 17.9% - 95.6%). APN was associated with bacteremia in 2.8% with hospitalization for 45.2% and mortality of 11.1% (due to severe acute malnutrition, severe dehydration and multifocal infection). Conclusion: The APN, daily activity of pediatrician in Bamako, is observed in one third of febrile children associated with a major life-threatening condition of risk factors, then the likely antibiotherapy could be amikacin in our context. 展开更多
关键词 APN FEVER CHILD BAMAKO
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Childhood Tuberculosis: A Descriptive Study in the Pediatric Ward of a University Hospital in Abidjan 认领
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作者 G. L. S. Couitchéré S. J. E. Enoh +2 位作者 G. B. Aka L. Zaho L. Cissé 《儿科学期刊(英文)》 2020年第1期206-216,共11页
Introduction:?Tuberculosis is one of the top ten causes of death in the world. Purpose:?The purpose of this study was to describe the different locations of tuberculosis and the diagnostic means used in our department... Introduction:?Tuberculosis is one of the top ten causes of death in the world. Purpose:?The purpose of this study was to describe the different locations of tuberculosis and the diagnostic means used in our department. Methods:?This was a descriptive retrospective study of children under 15 years of age admitted in 2018 for tuberculosis. The variables under study were socio-demographic, clinical, paraclinical and evolutionary data Results:?Forty-eight children were enrolled. The median age was 8.2 years (± 4.5) and the M/F ratio was 1.4. TB contamination was found?in 20.8% of cases and the index was often a family member (80%). The median diagnostic time was 49 (± 33) days. Six patients had positive HIV serology, 82% had acute malnutrition and lung examination was abnormal in the majority of cases (70.8%). Thorax-ray abnormalities were common (81%) and tuberculin skin testing was positive in 70.6% of cases. The diagnosis was confirmed in 29.2% of the children and the confirmatory examinations were direct examination (9 cases), lymph node biopsy (4?cases) and rapid test (Expert MTB/RIF) (one case). In 70.8% of cases, this was a diagnostic presumption. Pulmonary tuberculosis accounted for 72.9% of which 39.6% multifocal forms and extra-thoracic form 27.1%. Thirty-nine patients had received standard TB treatment and death occurred in 22.9% of cases. Conclusion:?Children are a high-risk population for TB, especially in cases of family infection. Contacts screening through a systematic approach to diagnosis will reduce deaths. Diagnostic difficulties can be partly overcome by improving the accessibility of rapid testing. 展开更多
关键词 TUBERCULOSIS CHILD DIAGNOSIS
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儿童咳嗽变异型哮喘误诊为呼吸系统感染原因分析 认领
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作者 柳俊芳 刘红 +3 位作者 许丽娟 付丽 滕瑞红 刘英杰 《临床误诊误治》 2020年第5期1-4,共4页
目的探讨儿童咳嗽变异型哮喘(cough variant asthma, CVA)的临床特点、误诊原因及防范措施。方法对曾误诊为呼吸系统感染的儿童CVA 23例的临床资料进行回顾性分析并复习相关文献。结果本组误诊率23.96%。23例均以慢性咳嗽就诊,呈反复或... 目的探讨儿童咳嗽变异型哮喘(cough variant asthma, CVA)的临床特点、误诊原因及防范措施。方法对曾误诊为呼吸系统感染的儿童CVA 23例的临床资料进行回顾性分析并复习相关文献。结果本组误诊率23.96%。23例均以慢性咳嗽就诊,呈反复或持续咳嗽,时轻时重,以清晨明显,皆伴少量白色黏液样痰。咽部充血14例;双肺呼吸音增粗10例,可闻及干湿性啰音6例,可闻及哮鸣音2例。胸部X线检查示肺纹理增粗12例。血白细胞升高6例,中性粒细胞升高7例。初步诊断为上呼吸道感染5例、慢性支气管炎12例、支气管肺炎6例。误诊时间1~12(8.57±2.36)个月。23例按呼吸系统感染给予对症治疗后,病情均无明显改善或加重。后进一步行支气管舒张及激发试验、肺功能检查、皮肤变应原试验,结合病史和家族史等,确诊为CVA,给予相应治疗后病情稳定。随访1年,21例咳嗽症状消失,2例仍有咳嗽症状,但发作频率降低。结论 CVA临床表现缺乏特异性,易误诊。临床接诊长期反复慢性咳嗽患者时,应考虑到CVA,要详细询问病史、开阔诊断思维、综合全面分析病情,并及时行支气管舒张及激发试验、肺功能检查、皮肤变应原试验等特异性检查,以减少或避免CVA误诊误治。 展开更多
关键词 哮喘 儿童 误诊 呼吸道感染 支气管炎 慢性 支气管肺炎
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儿童口呼吸的诊断与处理 认领
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作者 曾祥龙 高雪梅 《中华口腔医学杂志》 CAS CSCD 北大核心 2020年第1期3-8,共6页
儿童口呼吸问题日益受到医学界和社会的关注,口呼吸可分为习惯性和病理性口呼吸。其中由于腺样体和(或)扁桃体肥大导致的病理性口呼吸往往是儿童阻塞性睡眠呼吸暂停低通气综合征的病因,可能导致颅颌面畸形等后果。目前关于口呼吸的定义... 儿童口呼吸问题日益受到医学界和社会的关注,口呼吸可分为习惯性和病理性口呼吸。其中由于腺样体和(或)扁桃体肥大导致的病理性口呼吸往往是儿童阻塞性睡眠呼吸暂停低通气综合征的病因,可能导致颅颌面畸形等后果。目前关于口呼吸的定义和诊治方面尚存在不少问题,需要澄清。 展开更多
关键词 口呼吸 儿童 诊断 危险处理
以颅内静脉窦血栓为首发表现的急性单核细胞白血病1例报告并文献复习 认领
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作者 陈先睿 黄建琪 +3 位作者 郭碧赟 温红 白海涛 许锦平 《临床荟萃》 CAS 2020年第1期76-79,共4页
回顾性分析1例儿童儿童急性单核细胞白血病伴发颅内静脉窦血栓的临床表现、实验室检查、治疗经过及预后,并结合文献复习进行分析。儿童急性单核细胞白血病以颅内静脉窦血栓为首发表现缺乏特异性,在积极抗凝抗血栓治疗的同时应尽早找出... 回顾性分析1例儿童儿童急性单核细胞白血病伴发颅内静脉窦血栓的临床表现、实验室检查、治疗经过及预后,并结合文献复习进行分析。儿童急性单核细胞白血病以颅内静脉窦血栓为首发表现缺乏特异性,在积极抗凝抗血栓治疗的同时应尽早找出原发病避免漏诊和误诊。 展开更多
关键词 白血病 单核细胞 急性 窦血栓形成 颅内 儿童
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一步法与二步法腹壁穿刺行腹腔镜小儿疝囊高位结扎术临床对比分析 认领 被引量:1
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作者 翟佳琪 尚培中 +5 位作者 苗建军 刘冰 石德光 李晓武 杜欣 郭宏荣 《中华普外科手术学杂志(电子版)》 2020年第2期193-196,共4页
目的对比分析腹腔镜疝囊高位结扎术治疗小儿腹股沟斜疝术中采用钳式穿刺针一步法腹壁穿刺(一步法)与采用硬膜外穿刺针二步法腹壁穿刺(二步法)的安全性及临床效果。方法回顾性分析2015年3月至2018年6月身高≤120 cm、疝囊颈前后直径≤1.5... 目的对比分析腹腔镜疝囊高位结扎术治疗小儿腹股沟斜疝术中采用钳式穿刺针一步法腹壁穿刺(一步法)与采用硬膜外穿刺针二步法腹壁穿刺(二步法)的安全性及临床效果。方法回顾性分析2015年3月至2018年6月身高≤120 cm、疝囊颈前后直径≤1.5 cm的小儿单侧腹股沟斜疝患者147例临床资料, 64例患儿为二步法组, 83例患儿为一步法组,应用SPSS 17.0软件进行统计学分析,术中术后各项指标采用(x±s)表示,采用独立t检验;1年复发率采用χ^2检验,P<0.05为差异有统计学意义。结果一步法组与二步法组相比,手术时间分别为(11.8±3.2) min和(12.4±2.9) min,术中出血量分别为(1.7±1.3) ml和(1.9±1.3) ml,发现对侧隐匿性疝例数分别为10例(12.0%)和8例(12.5%),术后24 h疼痛评分分别为(1.2±0.6)分和(1.3±0.5)分,发生阴囊(阴唇)肿胀分别为0例和1例(1.6%),住院时间分别为(2.1±1.1) d和(2.2±1.1) d,术后1年复发率分别为2.4%(2/83)和3.1%(2/64),上述7项指标两组差异均无统计学意义(均P>0.05)。结论对身高≤120 cm、疝囊颈前后直径≤1.5 cm的小儿单侧腹股沟斜疝施行腹腔镜疝囊高位结扎术,无论采用一步法或是二步法腹壁穿刺,均可获得良好的临床治疗效果,两组术后1年复发率相当。 展开更多
关键词 腹股沟 儿童 腹腔镜检查 结扎术
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哌甲酯及托莫西汀联合脑电生物反馈与单纯脑电生物反馈治疗儿童注意缺陷多动障碍的疗效对比观察 认领
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作者 刘文龙 王真真 +1 位作者 张娟 王娟 《中国妇幼保健》 CAS 2020年第4期657-660,共4页
目的 探讨哌甲酯(MPH)及托莫西汀(ATX)联合脑电生物反馈(EEG-B)与单纯EEG-B治疗儿童注意缺陷多动障碍(ADHD)的疗效,为临床治疗提供参考依据。方法 64例ADHD儿童随机分成A、B、C 3组,A组予MPH,B组予ATX,同时联合EEG-B,C组仅予EEG-B,以整... 目的 探讨哌甲酯(MPH)及托莫西汀(ATX)联合脑电生物反馈(EEG-B)与单纯EEG-B治疗儿童注意缺陷多动障碍(ADHD)的疗效,为临床治疗提供参考依据。方法 64例ADHD儿童随机分成A、B、C 3组,A组予MPH,B组予ATX,同时联合EEG-B,C组仅予EEG-B,以整合视听持续性操作测试(IVA-CPT)、SNAP-IV问卷为评价工具,比较疗效差异。结果 3组在综合控制力商数和多动/冲动量表得分上均有改善,治疗前后比较差异有统计学意义(均P<0.05);在综合注意力商数和注意力量表得分上均有改善,仅A、B组差异有统计学意义(均P<0.05);两两比较,除多动/冲动量表外,其余结果显示A、B两组差异无统计学意义(均P>0.05),但与C组差异有统计学意义(均P<0.05)。结论 MPH及ATX联合EEG-B可以改善ADHD患儿的核心症状,两者疗效相当,且较单纯的EEG-B治疗更有优势;单纯EEG-B改善ADHD患儿的多动/冲动症状优于注意缺陷症状。 展开更多
关键词 注意缺陷多动障碍 儿童 哌甲酯 托莫西汀 脑电生物反馈 疗效
Gorham-Stout综合征的研究进展 认领
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作者 赵书一 刘天婧 王恩波 《中华小儿外科杂志》 CSCD 北大核心 2020年第3期280-284,共5页
Gorham-Stout综合征(Gorham-Stout syndrome,GSS)是一种罕见的病因不明的疾病,可能发生在任何年龄,但在儿童和青年人中最常见,其特征是大块骨溶解为特征的类肿瘤样损害。患者常表现为多发骨溶解、肿胀、疼痛、活动受限,严重的引起病理... Gorham-Stout综合征(Gorham-Stout syndrome,GSS)是一种罕见的病因不明的疾病,可能发生在任何年龄,但在儿童和青年人中最常见,其特征是大块骨溶解为特征的类肿瘤样损害。患者常表现为多发骨溶解、肿胀、疼痛、活动受限,严重的引起病理性骨折。因该病发病率低,报道以病例报告为主,目前尚无明确的诊疗标准,对临床医生的参考价值有限。现针对Gorham-Stout综合征的病因及发病机制、临床表现、影像学表现、病理学表现、诊断、鉴别诊断、并发症、治疗及预后作一综述,以提高临床医生对这一疾病的认识。 展开更多
关键词 骨质溶解 原发性 儿童 淋巴管
肺炎链球菌感染相关溶血尿毒综合征1例及文献复习 认领
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作者 李广波 刘翠华 《中国感染控制杂志》 CAS CSCD 北大核心 2020年第2期177-180,共4页
目的了解儿童肺炎链球菌感染相关溶血尿毒综合征(SP-HUS)的临床特点及治疗转归。方法回顾性分析1例采用血浆置换(PE)治疗SP-HUS患儿的临床资料,并查阅相关文献进行分析。结果患儿男性,3岁3个月,因咳嗽10 d,加重伴发热、胸痛3 d为代主诉... 目的了解儿童肺炎链球菌感染相关溶血尿毒综合征(SP-HUS)的临床特点及治疗转归。方法回顾性分析1例采用血浆置换(PE)治疗SP-HUS患儿的临床资料,并查阅相关文献进行分析。结果患儿男性,3岁3个月,因咳嗽10 d,加重伴发热、胸痛3 d为代主诉入院,具有溶血尿毒综合征(HUS)三联征,肺泡灌洗液培养和痰培养均为肺炎链球菌,诊断SP-HUS成立,经积极抗感染同时联合3次连续性肾替代治疗(CRRT)和2次PE治疗,患儿病情逐渐好转出院。文献复习发现,国内报道的两例SP-HUS患儿年龄分别为1岁6个月、3岁,均以肺炎起病,经积极抗感染和支持对症治疗,均好转出院。结论对于肺炎链球菌感染患儿应加强重视,警惕并发HUS,婴幼儿为高危人群,综合治疗是治疗成功的关键。 展开更多
关键词 溶血尿毒综合征 肺炎链球菌 儿童
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单纯经胸超声引导经皮介入治疗儿童房间隔缺损合并肺动脉瓣狭窄的疗效 认领
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作者 卢绪宁 文平 +6 位作者 刘启龙 刘宇航 高文 赵烨 于生喜 朱全伟 王宁 《中华全科医师杂志》 2020年第1期49-51,共3页
回顾分析大连市儿童医院2015年3月至2018年3月收治的继发孔房间隔缺损合并肺动脉瓣狭窄患儿23例,患儿均在经胸超声心动图引导下经股静脉同期行房间隔缺损封堵术及肺动脉瓣球囊扩张术,手术顺序为先封堵后球囊扩张。其中20例患儿房间隔缺... 回顾分析大连市儿童医院2015年3月至2018年3月收治的继发孔房间隔缺损合并肺动脉瓣狭窄患儿23例,患儿均在经胸超声心动图引导下经股静脉同期行房间隔缺损封堵术及肺动脉瓣球囊扩张术,手术顺序为先封堵后球囊扩张。其中20例患儿房间隔缺损封堵及肺动脉瓣球囊扩张均成功,3例患儿房间隔缺损封堵后,肺动脉瓣跨瓣压差<35 mmHg(1 mmHg=0.133 kPa),未行球囊扩张。术后随访,所有患儿肺动脉瓣跨瓣压差均<35 mmHg[(19.5±1.9)mmHg],与术前[(62.0±7.8)mmHg]相比差异有统计学意义(t=28.92,P<0.01),其中少量反流3例,余20例患儿未见肺动脉瓣反流;房间隔水平无残余分流,封堵器位置良好。提示单纯经胸超声引导下经皮介入同期治疗儿童房间隔缺损合并肺动脉瓣狭窄安全有效,先封堵房间隔缺损,部分患儿肺动脉瓣狭窄可缓解。 展开更多
关键词 肺动脉瓣狭窄 房间隔缺损 儿童 经胸超声
髓鞘少突胶质细胞糖蛋白抗体阳性的儿童中枢神经系统脱髓鞘疾病临床特点 认领
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作者 花奕 张卫琴 +4 位作者 沈珏 毛姗姗 袁哲锋 江佩芳 高峰 《中华实用儿科临床杂志》 CSCD 北大核心 2020年第6期450-453,共4页
目的探讨髓鞘少突胶质细胞糖蛋白(MOG)抗体阳性的儿童中枢神经系统(CNS)脱髓鞘疾病的临床特点及疗效。方法回顾性分析2017年3月至2019年2月在浙江大学医学院附属儿童医院神经内科住院的CNS脱髓鞘疾病患儿115例,其中MOG抗体阳性的CNS脱... 目的探讨髓鞘少突胶质细胞糖蛋白(MOG)抗体阳性的儿童中枢神经系统(CNS)脱髓鞘疾病的临床特点及疗效。方法回顾性分析2017年3月至2019年2月在浙江大学医学院附属儿童医院神经内科住院的CNS脱髓鞘疾病患儿115例,其中MOG抗体阳性的CNS脱髓鞘疾病患儿28例,总结28例患儿临床特点。结果28例患儿中男10例,女18例,男女比例为1.00∶1.80;起病中位年龄7岁9个月。临床症状表现多样,主要包括头痛、呕吐、嗜睡等脑病症状(13/28例),视力下降(7/28例),脊髓症状(6/28例),共济失调、口齿不清等小脑症状(4/28例),抽搐(2/28例),颅神经症状(1/28例)。24例行脑脊液检查,其中10例(41.7%)白细胞数轻度升高,2例(8.3%)蛋白升高,6例(25.0%)MOG抗体阳性,24例脑脊液寡克隆区带均阴性。25例头颅磁共振成像(MRI)阳性,阳性率为89.3%,常见累及部位包括大脑白质(20/28例)、小脑(10/28例)、大脑半球灰质(9/28例)、丘脑/基底核区(6/28例)、脑干(6/28例)、视神经(5/28例)和胼胝体(4/28例)。28例患儿中,13例脊髓受累,累及颈髓10例,胸髓9例,腰髓5例,8例患儿脊髓累及≥3个节段的长节段脊髓病变。14例患儿进行视觉诱发电位检查,2例临床无视觉障碍表现的患儿存在亚临床视觉损害。患儿均接受大剂量甲泼尼龙冲击治疗,16例联合丙种球蛋白免疫调节治疗,急性期均临床症状缓解,随访中7例患儿病情复发,复发率为25.0%,复发患儿再次使用甲泼尼龙冲击治疗联合丙种球蛋白免疫调节治疗,临床症状可缓解。结论MOG抗体阳性的儿童CNS脱髓鞘疾病临床表型以急性播散性脑脊髓炎为主,脊髓以累及颈胸段为主。其治疗以糖皮质激素和丙种球蛋白为主,疗效显著,但易复发,复发后再次使用糖皮质激素和丙种球蛋白,疗效仍较好。 展开更多
关键词 髓鞘少突胶质细胞糖蛋白抗体 儿童 中枢神经系统脱髓鞘疾病
发热、多变的皮疹及消化道出血一例分析 认领
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作者 舒静 何强 +1 位作者 陈芳 莫鑫 《中国全科医学》 CAS 北大核心 2020年第8期985-988,共4页
白塞病是一种累及多系统、多器官的全身性疾病,基本病理改变为免疫复合物介导的血管炎,可以累及任何大小和类型的血管,临床表现多样而复杂,病情呈反复发作和缓解的交替过程,而实验室检查结果无特异性,早期诊断极其困难。儿童白塞病早期... 白塞病是一种累及多系统、多器官的全身性疾病,基本病理改变为免疫复合物介导的血管炎,可以累及任何大小和类型的血管,临床表现多样而复杂,病情呈反复发作和缓解的交替过程,而实验室检查结果无特异性,早期诊断极其困难。儿童白塞病早期临床症状不典型,特异性强,病情可在短期内迅速进展。本文对1例白塞病患儿的病情演变、诊疗过程进行回顾分析,并进行相关文献复习,使临床医生提高对本病的认识,尽快正确诊断,以便早期开展疾病管理,防治急危重症。 展开更多
关键词 贝赫切特综合征 儿童 皮疹 消化道出血 病例报告
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穴位贴敷治疗小儿肺炎咳嗽选穴及用药规律分析 认领
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作者 魏洪悦 谷晓玲 《中华现代护理杂志》 2020年第1期80-83,共4页
目的采用聚类分析方法分析穴位贴敷治疗小儿肺炎咳嗽选穴及用药规律。方法计算机检索国内外主要数据库中有关穴位贴敷治疗小儿肺炎咳嗽的文献,对符合纳入研究标准的文献应用Excel软件由2名研究者独立进行数据提取,提取内容包括文献名称... 目的采用聚类分析方法分析穴位贴敷治疗小儿肺炎咳嗽选穴及用药规律。方法计算机检索国内外主要数据库中有关穴位贴敷治疗小儿肺炎咳嗽的文献,对符合纳入研究标准的文献应用Excel软件由2名研究者独立进行数据提取,提取内容包括文献名称、腧穴及药物选择等。以腧穴和药物分别作为唯一变量,统计出现频次,并对腧穴和药物出现10次及以上者,采用SPSS 19.0软件进行聚类分析。结果共纳入120篇相关研究,均为中文文献,共提及28个穴位,共计出现350次。使用频次在10次及以上的有8种;113篇文献提及使用穴位贴敷药物组成,共涉及97味中药,总计出现634次;使用频次在10次以上的有13味中药。结论穴位贴敷辅助治疗小儿肺炎咳嗽方法中,最常使用的穴位为肺俞、天突、膻中、阿是穴,最常使用的药物为白芥子、大黄、麻黄、细辛。 展开更多
关键词 肺炎 儿童 咳嗽 聚类分析 穴位贴敷
烧伤患儿的疼痛评估及非药物干预研究进展 认领
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作者 吴巍巍 路英慧 +1 位作者 程丹 吴世锋 《中华烧伤杂志》 CAS CSCD 北大核心 2020年第1期76-80,共5页
小儿是发生烧伤的高危人群,烧伤疼痛是一种特殊类型的疼痛。由于不同年龄段的患儿对疼痛的认知能力及行为反应存在差异,故针对小儿进行有效疼痛评估尤为困难。了解患儿的疼痛,明确疼痛的不良反应,及时有效地评估及采取合适的疼痛干预措... 小儿是发生烧伤的高危人群,烧伤疼痛是一种特殊类型的疼痛。由于不同年龄段的患儿对疼痛的认知能力及行为反应存在差异,故针对小儿进行有效疼痛评估尤为困难。了解患儿的疼痛,明确疼痛的不良反应,及时有效地评估及采取合适的疼痛干预措施对于医护人员至关重要。本文针对小儿烧伤疼痛的不同评估方法及非药物干预相关措施进行综述,以期为临床提供参考。 展开更多
关键词 烧伤 儿童 疼痛 管理
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