肺炎是婴幼儿时期的常见病、多发病,死亡率占第一位。重症肺炎伴低钙血症死亡率更高。现将我院儿科收治的婴幼儿重症肺炎伴低钙血症14例病例情况,现报道如下。 临床资料:本组14例重症肺炎均符合1984年10月广西南宁会议标准。其中男9例,女5例。新生儿2例,～6个月5例,～1岁4例,～3岁3例。呼吸衰竭6例,呼吸衰竭心力衰竭并存者7例,中毒性脑病1例,贫血1例,先天性心脏病1例。临床均有发热、喘憋、烦躁、精神萎靡、气急、口唇发绀、鼻翼扇动,三凹征阳性。双肺布满湿罗音。X线胸片示:双肺纹理增强模糊4例,双肺斑片状或絮状阴影10例,其中合并肺气肿3例,肺叶不张1例,叶间积液2例。本组均按肺炎常规给抗感染、吸氧、镇静、平喘、强心、纠酸等综合治疗。血钙低于2.0mmol/L为低钙血症。其中低于1.6mmol/L者4例,1.61～2.0mmoi/L者10例,将血钙低于1.6mmol/L4例给10％葡萄糖酸钙5～10ml,加10％葡萄糖10～20ml,1日2次静脉滴注。另10例不补充钙剂。本组14例均给钙通道阻滞剂硝苯吡啶口服,剂量为每次每千克体重0.2～0.5mg,1日2～3次,用药6～10天,死亡1例,余均治愈。 讨论 婴幼儿重症肺炎伴低钙血症,其原因是肺部炎症造成通气换气功能障碍,严重缺氧,加重了甲状旁腺功能损害,影响了甲状旁腺对血钙的调节,使血钙 Pneumonia is a common disease in infants and young children, frequently-occurring disease, mortality ranked first. Severe pneumonia with hypocalcemia higher mortality. Now our hospital admitted to pediatric severe pneumonia with hypocalcemia in 14 cases, are reported below. Clinical data: 14 cases of severe pneumonia in this group are in line with the meeting in 1984 Nanning, Guangxi standards. There were 9 males and 5 females. 2 neonates, ~ 6 months in 5 cases, ~ 1 year in 4 cases, ~ 3 years in 3 cases. 6 cases of respiratory failure, 7 cases of respiratory failure accompanied by heart failure, 1 case of toxic encephalopathy, 1 case of anemia and 1 case of congenital heart disease. Clinical fever, wheezing, irritability, apathetic, shortness of breath, cyanotic lips, nose flap, three concave sign positive. The lungs are full of wet rales. X-ray showed: double lung texture enhancement fuzzy 4 cases, double patchy or flocculent shadows in 10 cases, of which 3 cases of emphysema, lobular atelectasis, interstitial fluid in 2 cases. This group are routine pneumonia to anti-infection, oxygen, calm, asthma, cardiac, correcting acid and other comprehensive treatment. Serum calcium less than 2.0mmol / L hypocalcemia. 4 cases of less than 1.6mmol / L, 1.61 ~ 2.0mmoi / L in 10 cases, the serum calcium less than 1.6mmol / L 4 cases to 10% calcium gluconate 5 ~ 10ml, plus 10% glucose 10 ~ 20ml, 1 Day 2 intravenous drip. The other 10 cases did not add calcium. The group of 14 patients were given calcium channel blocker nifedipine oral dose of 0.2 ~ 0.5mg per kg body weight, 1 2 to 3 times, medication 6 to 10 days, 1 patient died, I were cured. Discussion Infant severe pneumonia with hypocalcemia, the reason is that lung inflammation caused by ventilation dysfunction, severe hypoxia, aggravating parathyroid dysfunction, affecting the regulation of blood calcium by the parathyroid, the blood calcium