小儿胸腔积液82例病因及临床特征分析  

Analysis of the etiologies and clinical characteristics of 82 cases of pleural effusion in children

作　　者：夏万敏[1] 王莉[1] 杨亚静[1] 

机构地区：[1]四川省成都市儿童医院呼吸科,四川成都610017

出　　处：《中国实用儿科杂志》2007年第12期916-918,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的探讨胸腔积液的病因和临床特征。方法回顾性分析成都市儿童医院1995-01—2006-05有明确病因的82例胸腔积液住院患儿的临床资料。结果(1)82例胸腔积液患儿中以感染为首位原因,其中化脓性感染42例(51.2%)、结核16例(19.5%)、支原体感染9例(11.0%),并殖吸虫感染2例(2.4%);非感染性原因包括:恶性肿瘤5例(淋巴瘤2例,白血病2例,肝癌伴肺转移1例),川崎病4例,肾病综合征4例;(2)有52例行胸腔穿刺抽液常规生化检查,符合渗出液改变的48例,漏出液4例。胸腔积液细胞培养阳性11例,其中肺炎克雷伯菌1例,肺炎链球菌4例,金黄色葡萄球菌6例;支原体-IgM(+)4例。(3)不同年龄组引起胸腔积液的原因有所差异,≤3岁组以化脓性最多见,表现为白细胞明显升高,胸腔积液呈明显化脓性改变,合并肺炎为特征,与>3岁组相比较差异有非常显著性(χ2=11.57,P<0.01);结核性感染中,>7岁儿童多见,与≤7岁儿童相比,差异有显著性(χ2=5.47,P<0.05);在支原体感染中,>3岁儿童较≤3岁儿童多见,差异也有显著性(χ2=3.837,P=0.05)。结论小儿胸腔积液的病因以感染为主,而感染又以化脓、结核、支原体为三大主因,随年龄不同其病因有所不同。Objective To investigate the the etiologies and clinical characteristics of pleural effusion in children. Methotis The clinical data of 82 cases of children＇s pleural effusion from 1995-01-2006-05 in hospital were analyzed retrospectively. Results In the study ,infection was the most common cause of pleural effusion. There were 42 cases caused by suppuration（51.2% ） , 16 cases by tuberculous empyema（ 19. 5%） ,9 cases caused by mycoplasma（ 11.0% ） ,2 cases caused by distoma pulmonala（ 2.4%）. Non-infection cause included 13 cases ：5 cases caused by malignant tumor;4 cases caused by Kawasaki disease ;4 cases caused by nephrofic syndrome. A total of 52 cases were performed the thoraeentesis： 48 cases showed exudates ;4 cases showed transudates. There were 11 positive cases in the pleural fluids of 52 cases cultured. There was 1 case caused by Klebsiella pneumonia ,4 cases caused by streptococcus pneumoniae and 6 cases caused by staphylococcus aureus pneumonia. Pleural fluids mycoplasma IgM of 4 cases was positive. Causes of different ages were different. In under-3-year group, suppuration was the main cause, which showed statistical difference compared with that in over-3-year group （ χ^2 = 11.57, P 〈 0. 01）. In under-7-year group, the cause of tuberculous empyema showed statistical difference compared with that in over-7-year group （ χ^2 = 5.47, P 〈 0. 05）. In under-3-year group, the cause of mycoplasma showed statistical difference compared with that in over-3-year group （ χ^2= 3.837, P = 0. 05）. Conclusion In the children, infection is the most common cause of pleural effusion. Suppuration, tuberculous empyema and mycoplasma were the main infective causes. The cause is different in the children of different ages.

关 键 词：胸腔积液 儿童 病因 临床特征 

分 类 号：R72[医药卫生—儿科]