摘要
【摘要】目的分析儿童咯血的病因分布，并对儿童咯血的程序性诊断方法进行探讨。方法回顾性分析湖南省儿童医院呼吸内科病房2012年6月至2015年6月收治的42例咯血患儿的临床资料，根据病因进行分类，并对程序性诊断方法进行总结和评估，最终的诊断结果分为明确诊断和病因未明。结果明确诊断41例（97．6％），病因未明1例（2．4％）。感染为主要病因，包括肺炎8例（19．0％）、支气管炎5例（11．9％），其他依次为支气管动脉一肺动脉瘘10例（23．8％）、肺含铁血黄素沉着症8例（19．0％）、支气管扩张5例（11．9％）、肺大血管畸形并肺动脉高压3例（7．2％）、肺结核1例（2．4％）、支气管异物1例（2．4％）。13例呼吸道感染及5例支气管扩张患儿通过胸部CT确诊，10例支气管动脉一肺动脉瘘患儿通过血管造影确诊，8例肺含铁血黄素沉着症、1例肺结核及1例支气管异物患儿通过纤维支气管镜确诊，3例肺大血管畸形并肺动脉高压患儿通过多排螺旋CT血管造影技术、心脏彩超确诊。结论儿童咯血是一组异质性疾病，病因复杂。采用程序性诊断方法能明确大多数咯血患儿的诊断，病史、纤维支气管镜、多排螺旋CT血管造影技术、心脏彩超、数字减影血管造影在儿童咯血的病因诊断中发挥重要作用。
Objective The purpose of the study was to investigate the causes of hemoptysis and ex- plore the diagnostic procedures for hemoptysis in children. Methods The medical records of 42 children with hemoptysis admitted to the Respiratory Department of Hunan Children＇s Hospital from June 2012 to June 2015 were collected by a retrospective study. The causes of hemoptysis were classified by pathogenesis, and the diagnosis of hemoptysis was evaluated in this study. The final diagnosis was divided into clear diagnosis and the cause was unknown. Results A total of 41 （97. 6% ） cases were diagnosed, 1 （2. 4% ） case was not diagnosed. In 42 cases of hemoptysis, infection was the main cause of the disease, including 8 （ 19.0% ） cases of pneumonia and 5 （ 11.9% ） cases of bronchitis, and the following causes were bronchial artery fistula（ 10/ 42,23.8 % ）, idiopathic pulmonary hemosiderosis （8/42,19. 0% ）, bronchiectasis （5/42,11.9 % ）, pulmonary vascular malformation with pulmonary hypertension （3/42,7.2%）, pulmonary tuberculosis （2.4%）, bronchi- al foreign body（ 1/42,2.4% ） respectively. Thirteen cases of respiratory tract infection, and 5 cases of bron- chiectasis were diagnosed by chest CT, 10 cases with pulmonary artery fistula were diagnosed by digital sub- traction angiography, 8 cases of pulmonary hemosiderosis, 1 case of pulmonary tuberculosis, and 1 case with bronchial foreign body were diagnosed by fiberoptic bronchoscopy. Three cases of pulmonary vascular malfor- marion and pulmonary hypertension were diagnosed by row helical CT angiography and cardiac color ultra- sound. Conclusion Hemoptysis in children is a heterogeneous group of respiratory disorders. Most causes could be identified by using the diagnostic procedures. Other factors, including medical history, CT, fiber bronchoscopy,multidetector CT angiography, cardiac color ultrasound and digital subtraction angiography, play important roles in the diagnosis of hemoptysis in children.
出处
《中国小儿急救医学》
CAS
2016年第3期172-177,共6页
Chinese Pediatric Emergency Medicine
关键词
咯血
诊断程序
儿童
Hemoptysis
Diagnostic procedure
Children
