临床儿科杂志 ›› 2017, Vol. 35 ›› Issue (8): 580-.doi: 10.3969/j.issn.1000-3606.2017.08.005

• 呼吸系统疾病专栏 • 上一篇    下一篇

182 例重庆地区支气管扩张患儿临床特征及病因构成分析

刘娇, 刘恩梅, 邓昱   

  1. 重庆医科大学附属儿童医院呼吸中心 儿童发育疾病研究教育部重点实验室 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)
  • 收稿日期:2017-08-15 出版日期:2017-08-15 发布日期:2017-08-15
  • 通讯作者: 刘恩梅 E-mail:emliu186@126 .com
  • 基金资助:
    国家临床重点专科项目(No.[ 2011 ] 873)

Clinical features of bronchiectasis in 182 children in Chongqing with etiology analysis

LIU Jiao, LIU Enmei, DENG Yu   

  1. Department of Respiration, Children’s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
  • Received:2017-08-15 Online:2017-08-15 Published:2017-08-15

摘要: 目的 探讨儿童支气管扩张的常见病因及临床特征。方法 回顾分析1991年至2015年5月在重庆医科大学 附属儿童医院确诊为支气管扩张的住院患儿,以及中文数据库中,1990年至今病例数≥20例的支气管扩张患儿的病例资 料。结果 重庆地区支气管扩张182患儿例中男114例,女68例,中位年龄118个月。引起支气管扩张的前三位病因为感 染后(29.7%)、原发性免疫缺陷病(7.7%)和支气管异物(7.7%)。 慢性湿性咳嗽是儿童支气管扩张的主要表现,最常受 累肺叶为左肺下叶、右肺中叶和右肺下叶。确诊需结合胸部CT。支气管扩张抗生素选择依据呼吸道分泌物培养,重庆地 区最常见的分离菌为肺炎链球菌。另对重庆在内的中国7个城市共572例(男347例,女225例)支气管扩张儿童进行分析 发现,前三位病因与重庆相同,所占比例分别为感染后45.5%、原发性免疫缺陷病7.3%和支气管异物5.6%。结论 早期 诊断、识别病因和综合管理利于儿童支气管扩张的预后。

Abstract:  Objective To understand the etiology and clinical features of childhood bronchiectasis in China. Methods Data of 182 children diagnosed with bronchiectasis admitted in Children’s Hospital of Chongqing Medical University from 1991 to May, 2015, and more than 20 cases in the Chinese literatures since 1990 were reviewed. Results The top three causes of bronchiectasis in 182 children (114 boys, 68 girls, median age: 118 months) in Chongqing were post-infection, primary immunodeficiency and foreign body, with frequency of 29.7%, 7.7%, and 7.1%, respectively. Chronic wet cough was the most frequent feature. Diagnosis of bronchiectasis usually need to combine with chest CT findings, which showed that the lesions were at left lower lobe, right middle lobe and right lower lobe. The choice of antibiotics was based on bacterial cultures of respiratory secretions, and Streptococcus pneumoniae was the most frequently isolated bacteria in Chongqing. The most common three causes of bronchiectasis in children according to data of 572 cases ( 347 boys, 225 girls) in 7 cities of China including Chongqing were the same with that of Chongqing, 45.5%, 7.3%, and 5.6%, respectively. Conclusion Early diagnosis, identification of etiology and comprehensive management of bronchiectasis in children are benefitial for prognosis.