J Yu, CM Zhang, XF Lou

Abstract

Objectives: To recognise the clinical features and therapeutic experiences of critical pandemic influenza A (H1N1) virus infection in children. Methods: During the two waves of pandemic H1N1 virus infection, 41 severely ill children infected with pandemic H1N1 virus were admitted to the paediatric intensive care unit of the Children's Hospital, Zhejiang University, School of Medicine. Results: The total mortality of two pandemic waves was 41.5% (17/41). A total of 92.7% of children had fever. A total of 27 children were intubated and supported with a mechanical ventilator. The factor of younger age was associated with higher mortality. The time on oxygen and respirator use was longer in deaths than survivals. The ratio of complications of septic shock, acute respiratory distress syndrome, and air leak syndrome was higher in deaths than survivals. Conclusions: Critical pandemic H1N1 virus infection in children less than 3 years old leads to high mortality, and early diagnosis and treatment is pivotal for successful treatment.

目的：旨在認識兒童重症甲型流感病毒H1N1感染的臨床特徵和治療經驗。方法：在H1N1流感病毒兩次大流行期間，浙江大學醫學院附屬兒童醫院的兒童重症監護室共收治41例感染H1N1病毒的重症患兒。結果：2次大流行期的總死亡率為41.5%（17/41）。92.7%病人有發熱症狀。共有27例患兒進行了氣管插管和呼吸機輔助通氣。年齡越小的患兒死亡率越高。死亡的患兒同存活者相比，用氧和呼吸支持的時間更長，發生感染性休克，急性呼吸窘迫綜合症和氣漏綜合症等合併症的比例更高。結論：3歲以下的兒童帶重症流感H1N1病毒感染的死亡率較高，早期診斷和治療是成功治療的關鍵。