小儿肾病综合征合并肺动脉栓塞诊断和治疗(2例报告及文献复习)  

Clinical analysis of the pulmonary thrombosis in childhood nephrotic syndrome

作　　者：陈鹭[1] 王辉[1] 沈颖[1] 

机构地区：[1]首都医科大学附属北京儿童医院肾脏内科,100045

出　　处：《北京医学》2011年第2期163-166,共4页Beijing Medical Journal

摘　　要：目的探讨小儿肾病综合征合并费动脉栓塞的诊断与治疗。方法报告了2例我院肾脏内科2010年收治的肾病综合征合并肺动脉栓塞患儿,并对近年来小儿肺栓塞的相关研究资料进行综述分析。结果 2例患儿均出现发热、咳嗽,并伴有胸痛、咯血。误诊为肾病综合征合并肺部感染。分别行肺通气-灌注显像及胸部增强CT确诊肺动脉栓塞,给予抗凝、溶栓治疗后均提示有效。结论肾病综合征患儿突发咳嗽、胸痛等不适,应警惕肺动脉栓塞的可能,凝血功能是重要的检查之一。Objective Pulmonary thrombolism is an uncommon disease in children. Because of the clinically silent or presents with symptoms that can be explained by underlying diseases,it is easily be misdiagnosed. It is a complication of nephritic syndrome; Methods We present our experiences in managing two children of the pulmonary thrombosis with childhood nephritic syndrome; Results These two children in the course presented with fever,cough,chest pain and hemoptsis,and they were clinically misdiagnosed as lung infection. They were proved to be pulmonary thrombosis by helical computed tomography and ventilation-perfusion lung scanning eventually in our hospital. Then after anticoagulant and Thrombolytic therapy,they were improved; Conclusion Children with nephritic syndrome present with chest pain,cough,shortness of breath and hemoptsis,or the FIB,D-dimer are significantly increased,the attention should be paid to Pulmonary thrombolism. International or multicentre randomized controlled trials in the pediatric population for the diagnosis,treatment and outcome are needed.

关 键 词：儿童 肾病综合征 肺动脉栓塞 

分 类 号：R726.9[医药卫生—儿科]