孩子阳性了怎么办?家中要备啥药?专家详解

作者:(责编:coliving-lisbon(实习生)) 2022-12-09 08:13:43

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  中新网北京12月8日电(记者 阚枫)近期,伴随部分地区疫情发展态势变化,以及阳性感染者可居家隔离等政策发布,不少家长担心家中的孩子,特别是婴幼儿万一感染了怎么办。

  和成年人相比,儿童感染奥密克戎变异株会呈现出哪些症状?家长应该如何用药?孩子出现什么症状必须送医院诊疗?就这些话题,中新网采访了首都儿科研究所呼吸内科主任曹玲、中医科主任李敏。

资料图:翟李强 摄 资料图:翟李强 摄

  中新网:近期医院接诊的阳性患儿呈现哪些特点?

  李敏:奥密克戎BF.7变异株是北京本轮疫情的主要毒株。近20天,首都儿科研究所确诊的阳性患儿,从确诊患儿年龄分布来看,范围涉及新生儿至18岁儿童,其中,3岁以下儿童的占比较高。患儿多数以发热为主要就医原因,占全年龄段人群的98.31%,其次常见临床症状为咳嗽和流涕及咽痛,部分儿童有腹泻、头痛、呕吐、鼻塞、腹痛等。

  中新网:儿童一旦感染了会有哪些症状?一般病程会几天?

  曹玲:奥密克戎BF.7变异株主要导致上呼吸道感染,儿童病例症状较轻,可能会出现发热、咽干咽痛、咳嗽等症状,发热可为高热39摄氏度以上,浑身酸疼乏力,一般不超过3天。病程中如有明显憋气症状需用肺部影像检查来诊断是否有肺部感染。接种过新冠疫苗并完成加强免疫的人群病程更短、病情更轻。

  发病第一天,症状较轻,可能感到轻微咽干咽痛、身体乏力。

  发病第二天,开始出现发热症状,部分儿童高烧至39摄氏度左右。同时咽部不适感加重。

  发病第三天,症状最重的一天,高热39摄氏度以上,浑身酸疼乏力,咽痛加剧。

  发病第四天,体温的高峰开始下降。很多人从这一天体温降为正常,不再发热。但仍然咽痛咽痒。一部分人开始流涕、咳嗽。

  发病第五天,体温基本降到正常,但是鼻塞、流涕、咽痛、咳嗽,身体乏力仍然存在。

  发病第六天,不再发热,咳嗽、流涕等症状加重,因为前期病毒导致的呼吸道黏膜破坏,人体通过流涕、咳嗽排出坏死的细胞,这天部分患者可能出现核酸转阴。

  发病第七天,所有的症状开始明显好转,核酸很大可能转阴。

  中新网:阳性患儿应该如何用药?一般多久可以痊愈?

  曹玲:在新冠病毒的治疗方面,除了一些有基础疾病、肿瘤疾病的高风险因素患者会用到“新冠抗病毒药物”,大部分感染者只需对症治疗即可。冬季是呼吸道疾病的高发季,不论是新冠病毒还是流感病毒都非常活跃。为应对冬季呼吸道疾病的发生,建议家长可以简单备一些常用的儿童非处方药物,按照不同的年龄使用,对新冠、流感症状缓解都有效。

  1. 如果出现发热、头痛、咽痛明显影响休息,影响睡眠。可以服用解热镇痛的药物。建议使用适合儿童使用的布洛芬,对乙酰氨基酚;

  2. 如果出现痰多、咳痰费力的情况,建议使用乙酰半胱氨酸颗粒等;

  3. 如果鼻塞严重,可以短期使用羟甲唑啉鼻喷剂喷鼻。

  根据病毒自限性的特点,一般1-2周就会痊愈。除了用药,对抗新冠病毒更需要好好休息,饮食清淡,多喝水,多吃蔬菜水果,少吃或不吃辛辣食物。

  中新网:在中成药方面,家长可以准备哪些药品?

  李敏:儿童患者的中医证候特点、核心病机与成人基本一致。结合儿童患者临床症候和生理特点,可辨证选择儿童适用中成药酌量使用。但要特别注意的是,清热的中药制剂选用一种即可,以免出现药物过量风险。

  (一)发热治疗

  1. 对于发热,咽痛,大便干燥,舌红苔白或黄的儿童,可以使用清热散瘟口服液、或小儿豉翘清热颗粒、或双紫黄颗粒;

  2. 伴有轻微咳嗽者,可以使用连花清瘟胶囊/颗粒;

  3. 伴有大便粘腻不畅或腹泻,舌红苔白腻黄腻者,在上述中药基础上可以加用藿香正气软胶囊/口服液。

  4. 如果怕冷、手脚凉明显,可在上述中药基础上加小儿柴桂退热颗粒。

  (二)咳嗽、流涕

  1. 如果出现咳嗽,可以使用杏贝止咳口服液、清肺化痰口服液、复方鲜竹沥液等

  2. 如果鼻塞流涕比较明显,可以使用鼻炎清口服液等。

  3. 需要注意的是,儿童服用中药后可能出现大便次数增多,大于 3次/天,可以酌情将药量减半口服。如出现其他不适症状,需在医生指导下确定是否停药或进一步处理。有药物过敏史者,需在医生指导下服用。

  中新网:哪些情况下,家长必须带孩子去医院诊治?

  曹玲:如果在家出现持续高热超过三天仍没有缓解,甚至其他症状越来越重,有明显呼吸急促、喘憋,尤其是活动后憋气的情况,或是出现嗜睡、惊厥、拒食或喂养困难等神经或胃肠道表现、应立即前往医院就诊。对于有基础病的儿童,建议首选医院观察治疗。(完)

【编辑:唐炜妮】

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