儿童闭塞性细支气管炎的临床及高分辨率CT特点  

Clinical characteristics and high resolution CT findings of children with obliterative bronchiolitis

作　　者：尹丹萍[1] 李理[2] 孙钢[2] 

机构地区：[1]济南军区总医院疾病预防控制科,250031 [2]济南军区总医院医学影像科,250031

出　　处：《中华消化病与影像杂志（电子版）》2017年第4期150-152,共3页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

基　　金：2015年度济南军区总医院院长基金(2015QN02)

摘　　要：目的研究感染导致的儿童闭塞性细支气管炎(obliterative bronchiolitis,BO)临床特点及高分辨率CT(high resolution computerized tomography,HRCT)表现。方法本研究为回顾性研究,选择2014年1月至2016年1月于济南军区总医院确诊为BO的患儿32例作为观察对象,观察分析其临床表现、HRCT表现、肺功能检查结果、病原学检查等。结果所有患者均有喘息症状,29例伴有咳嗽症状,26例患儿呈持续或反复性细湿啰音,13例患儿活动后气促;HRCT检查中29例患者肺部充气不均匀,呈马赛克灌注征,25例可见磨玻璃影,17例患儿出现支气管壁增厚、支气管扩张等,3例可见网格影;肺功能检查中,27例患儿存在小气道通气功能障碍,2例患儿为混合型通气功能障碍,3例患者舒张试验均显示阴性。病原学检查阳性28例(87.5%),以腺病毒感染和肺炎支原体感染为主,阴性4例(12.5%)。结论儿童感染后BO临床表现各异,临床表现结合HRCT是正确早期诊断儿童BO的重要途径。Objective To investigate the clinical characteristics and high resolution CT（ HRCT）findings of children with obliterative bronchiolitis） OB） caused by infection. Methods A total of 32 children diagnosed with OB were enrolled in this retrospective study from January 2014 to January 2016 in General Hospital of Jinan Military Region. The clinical manifestations, HRCT findings, pulmonary function test results and pathogen examination were observed and analyzed. Results All patients had wheezing symptopatients had cough symptoms. Twenty patients presented persistent or repeated wet rales, and 13 patients exhibited shortness of breatli after the activities. HRCT results showed that uneven pulmonary irritation andmosaic perfusion sign were observed in 29 cases, glass opacity in 25 cases, bronchial wall thickening and bronchiectasis in 17 cases and mesh shadow in 3 cases. Pulmonary function test showed that 27 cases had small airway ventilation dysfunction, 2 cases had mixed ventilation dysfunction and 3 cases with diastolic test showed negative results. Pathological examination was positive in 28 cases （ 87. 5% ）, which mainly were adenovirus infection and mycoplasma pneumoniae infection, and the rest 4 cases （ 12. 5% ） were reportednegative. Conclusion The clinical manifestations of OB in children were quite different. It is very importantto make a diagnosis with clinical manifestations combined with HRCT findings.

关 键 词：儿童 闭塞性细支气管炎 临床特征 高分辨率CT 

分 类 号：R725.6[医药卫生—儿科] R816.92[医药卫生—临床医学]