儿童支气管结核的临床特点  

Clinical features of bronchial tuberculosis in children

作　　者：任红梅[1] 王影[2] 杨雪[1] 宋殿权 吴颖[1] 李迎春[1] 

机构地区：[1]沈阳市胸科医院结核四病房,沈阳110044 [2]中日友好医院中医消化科,北京100029

出　　处：《中国中西医结合儿科学》2016年第4期411-414,共4页Chinese Pediatrics of Integrated Traditional and Western Medicine

摘　　要：目的探讨儿童支气管结核的临床特点。方法 2007年3月至2013年3月沈阳市胸科医院结核内科收治支气管结核患儿32例,分析其临床资料,总结支气管结核的临床特点、诊断、治疗及预后。结果 （1）年龄7~14岁儿童支气管结核32例。确诊前误诊32例,误治时间2周至1年。确诊15例,临床诊断性抗结核治疗17例。（2）临床表现：发热21例,肺部闻及哮鸣音7例。（3）X线片异常32例;肺CT检查发现支气管淋巴结结核10例;发现支气管形态异常9例。（4）纤维支气管镜检查发现支气管结核32例。（5）病原学检查阳性率37.5%（12/32）。（6）病程中结核菌素试验阳性率达59.4%（19/32）。（7）接受抗结核治疗32例,治愈30例,失访2例。结论儿童支气管结核的临床表现不典型,诊断困难,误诊、漏诊率高,疗程长,治疗依从性差等因素直接影响结核病愈后。早发现、早诊断、及时治疗对控制结核病的进展,减少支气管结核的发生,减轻支气管结核患儿的临床症状,减少或防止并发症的发生,提高治愈率及改善预后起到至关重要的作用。Objective To study the clinical features of bronchial tuberculosis in children.Methods A total of 32 children with bronchial tuberculosis were admitted to Shenyang Chest Hospital from March 2007 to March 2013.The clinical data of these patients were analyzed to summarize the clinical features,diagnosis,treatment and prognosis of bronchial tuberculosis.Results（1）There were 32 cases of childhood bronchial tuberculosis,who aged 7to 14 years.Before the definite diagnosis,32 cases were misdiagnosed,and the time varied from 2weeks to one year.Fifteen cases had definite diagnosis and 17 cases received clinically diagnostic antituberculous treatment.（2）Clinical manifestation：there were 21 cases of fever and 7cases of wheezing rale.（3）Totally 32 cases had abnormal X-ray;lung CT showed bronchial lymphoid tuberculosis in10 cases and bronchial abnormalities in 9cases.（4）Fiberoptic bronchoscopy revealed that there were 32 cases of bronchial tuberculosis.（5）The positive rate in etiological examination was 37.5%（12/32）.（6）The positive expression rate of tuberculin test was 59.4%（19/32）in the disease course.（7）Totally 32 cases received antituberculous treatment,of which 30 were cured while 2were lost.Conclusion Childhood bronchial tuberculosis has atypical clinical manifestations,and it is difficult to be diagnosed with high misdiagnosis rate and missed-diagnosis rate.The long disease course and bad compliance in treatment have direct influence on its prognosis.Early detection and diagnosis and timely treatment are essential to controlling the disease progress,reducing the occurrence of bronchial tuberculosis,relieving the clinical symptoms,reducing and preventing complications,increasing the cure rate and improving the prognosis.

关 键 词：支气管结核 支气管淋巴结结核 临床特点 儿童 

分 类 号：R529.9[医药卫生—内科学]