摘要
目的探讨儿童肺脓肿的诊断和治疗。方法回顾分析94例肺脓肿患儿的临床资料。结果94例患儿中男57例、女37例,中位年龄2.3岁(范围1个月~17岁5个月);原发性肺脓肿54例,继发性肺脓肿40例。常见症状为发热、咳嗽、气促、呼吸困难和胸痛。继发性肺脓肿组白蛋白<30 g/L比例高,CRP水平高,差异均有统计学意义(P<0.05)。66例患儿病原检测阳性,共检出病原81株,原发性肺脓肿组以肺炎链球菌和肺炎支原体为主,继发性肺脓肿组则以金黄色葡萄球菌、肺炎链球菌、肺炎克雷伯菌为主。94例患儿均给予抗生素,2例抗真菌治疗,18例手术治疗。91例患儿好转出院;3例患儿结局不良(2例放弃治疗,1例死亡),均为继发性肺脓肿。与原发性肺脓肿组相比,继发性肺脓肿组进重症监护病房治疗比例更高,住院时间更长,差异均有统计学意义(P<0.05)。结论原发性和继发性肺脓肿患儿分别以肺炎链球菌及金黄色葡萄球菌感染多见,需抗生素治疗,部分需外科手术。继发性肺脓肿较原发性肺脓肿症状更严重,治疗时间长。
Objective To explore the diagnosis and treatment of pulmonary abscess in children.Method The clinical data of pulmonary abscess in 94 children were retrospectively analyzed.Results There were totally 94 children(57 boys and 37 girls)with a median age of 2.3 years(1 month to 17 years and 5 months),including 54 children with primary pulmonary abscess and 40 children with secondary pulmonary abscess.The common symptoms were fever,cough,shortness of breath,dyspnea and chest pain.Compared with primary pulmonary abscess group,the proportion of albumin<30 g/L and the level of CRP were higher in the secondary lung abscess group(P<0.05).Sixty-six children were detected positive for pathogens,and 81 strains were detected.Streptococcus pneumoniae and Mycoplasma pneumoniae were the main pathogens in primary pulmonary abscess group,while Staphylococcus aureus,Streptococcus pneumoniae and Klebsiella pneumoniae were the main pathogens in secondary pulmonary abscess group.All 94 patients were treated with antibiotics,2 with antifungal therapy and 18 with surgery.Ninety-one children were discharged after remission.Three patients had poor outcomes(2 gave up treatment and 1 died)and all of them were secondary pulmonary abscesses.Compared with the primary pulmonary abscess group,the secondary pulmonary abscess group had a higher proportion of ICU cases and longer hospital stay,and the differences were statistically significant(P<0.05).Conclusion Children with primary and secondary pulmonary abscesses are commonly infected with Streptococcus pneumoniae and Staphylococcus aureus,respectively,and the antibiotic treatment is required,and surgery is required in some cases.Secondary pulmonary abscess has more severe symptoms and longer treatment time than primary pulmonary abscess.
作者
谭静
李竹霞
雷银兰
杜鑫珂
舒畅
TAN Jing;LI Zhuxia;LEI Yinlan;DU Xinke;SHU Chang(Department of Respiratory Diseases,Children's Hospital of Chongqing Medical University,Ministry of Education Key Laboratory of Child Development and Disorders,National Clinical Research Center for Child Health and Disorders,China International Science and Technology Cooperation Base of Child Development and Critical Disorders,Chongqing Key Laboratory of Pediatrics,Chongqing 400014,China)
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2020年第10期730-735,共6页
Journal of Clinical Pediatrics
关键词
肺脓肿
临床特点
治疗
儿童
pulmonary abscess
clinical characteristic
treatment
child
