临床儿科杂志 ›› 2020, Vol. 38 ›› Issue (10): 730-.doi: 10.3969/j.issn.1000-3606.2020.10.003

• 呼吸系统疾病专栏 • 上一篇    下一篇

儿童肺脓肿94例临床分析

谭静, 李竹霞, 雷银兰, 杜鑫珂, 舒畅   

  1. 重庆医科大学附属儿童医院呼吸科 儿童发育疾病研究教育部重点实验室 国家儿童健康与疾病临床 医学研究中心 儿童发育重大疾病国家国际科技合作基地 儿科学重庆市重点实验室 (重庆 400014)
  • 出版日期:2020-10-15 发布日期:2020-10-10
  • 通讯作者: 舒畅 电子信箱:2382447745@qq.com

Clinical analysis of pulmonary abscess in 94 children

TAN Jing, LI Zhuxia, LEI Yinlan, DU Xinke, SHU Chang   

  1. 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
  • Online:2020-10-15 Published:2020-10-10

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。

关键词: 肺脓肿; 临床特点; 治疗; 儿童

Abstract: 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.

Key words: pulmonary?abscess;? clinical?characteristic;? treatment;? child