ISSN 1674-3865  CN 21-1569/R
主管:国家卫生健康委员会
主办:中国医师协会
   辽宁省基础医学研究所
   辽宁中医药大学附属医院

中国中西医结合儿科学 ›› 2017, Vol. 9 ›› Issue (4): 333-336.doi: 10.3969/j.issn.1674-3865.2017.04.019

• 临床研究 • 上一篇    下一篇

226例胸腔积液患儿病因及临床特点分析

李林瑞,杨敏,陈艳萍   

  1. 410007 长沙,湖南省儿童医院呼吸二科
  • 出版日期:2017-08-25 发布日期:2017-12-08
  • 通讯作者: 李林瑞,E-mail:3382549289@qq.com
  • 作者简介:李林瑞(1983-),女,医学硕士,主治医师。研究方向:小儿呼吸系统疾病的诊治

Analysis of the etiology and clinical characteristics of pleural effusion in 226 children

LI Linrui,YANG Min,CHEN Yanping   

  1. The Second Respiratory Department of Hunan Children's Hospital, Changsha 410007,China
  • Online:2017-08-25 Published:2017-12-08

摘要:
目的
探讨分析226例胸腔积液患儿的病因及临床特点,为临床诊治儿童胸腔积液提供依据。
方法
分析2013年1月至2014年1月湖南省儿童医院收治的226例胸腔积液患儿的临床资料(症状、体征、影像学检查、胸腔积液生化检测)。
结果
(1)感染性因素居首位,感染性胸腔积液209例(92.5%,209/226),临床考虑细菌感染性胸腔积液172例(76.1%),其中第一诊断为重症肺炎的48例(22.9%),麻疹并肺炎者3例(1.4%);支原体感染72例(31.8%);非感染因素17例(7.5%)。(2)50例做胸腔穿刺抽液检查,符合渗出性改变的48例,漏出性改变的2例。(3)痰培养阳性者有75例(33.2%)。(4)同一病因所致胸腔积液不同年龄段有所不同,支原体感染在<3岁以下者明显少于≥3岁患儿,结核感染所致者均在7岁以上,≤3岁组患儿在支原体感染患儿中占比较既往研究高;(5)平均住院时间16 d。
结论
儿童胸腔积液病因中感染性因素占首位;同一病因所致胸腔积液在不同年龄段有所不同,≤3岁患儿在支原体感染患儿中占比较既往研究高;胸腔积液患儿住院时间均较长。

关键词: 胸腔积液, 病因, 肺炎支原体, 感染, 儿童

Abstract:
Objective
To explore the etiology and clinical characteristics of pleural effusion in 226 children and to provide evidence for its clinical treatment.
Methods
The clinical data of 226 children with pleural effusion who were treated in Hunan Children's Hospital from Jan. 2013 to Jan. 2014 were including symptoms, signs, imaging examinations, and biochemical tests of pleural effusion.
Results
(1)Infectious factors ranked the first; there were 209 cases(92.5%,209/226) of infectious pleural effusion, and 172 cases were clinically considered as bacterial pleural effusion, of which the first diagnosis was severe pneumonia in 48 cases(22.9%), and measles with pneumonia in 3 cases(1.4%); there were 72 cases of Mycoplasma pneumniae infection(31.8%); 17 cases were irrelevant to infectious factors(7.5%).(2)Thoracentesis was performed in 50 cases, and 48 cases were in accordance with exudative change, 2 cases with leaking change.(3)There were 75 cases(33.2%) of positive phlegm culture.(4)Mycoplasma pneumoniae infection was obviously fewer in children under 3 than in those at or over 3 years old; tuberculous infection was only in the children over 7; the children at or under 3 years old accounted for higher proportion than before in Mycoplasma pneumonia infection.(5)Average hospital stay was 16d.
Conclusion
Infectious factors ranks the first in the causes of pleural effusion; the number of children with pleural effusion resulting from the same cause is different in different age groups, and the children at or under 3 years old account for higher proportion than before in Mycoplasma pneumoniae infection. The hospital stay of children with pleural effusion is comparatively long.

Key words: Pleural effusion, Etiology, Mycoplasma pneumoniae, Infection, Children