儿童脓胸49例临床分析  

Clinical analysis of empyema in 49 children

作　　者：杨志国[1] 张妮[2] 裴炜娜[1] 王海东[1] 陈永前[3] 吕海燕[3] 崔祎梅 YANG Zhiguo1, ZHANG Ni2, PEI Weina1, WANG Haidong1, CHEN Yongqian3, LYU Haiyan3, CUI Yimei 1(1. Intensive Care Unit, 2. Digestive Department, 3. Neurologic Department, The Children＇s Hospital of Lanzhou University＇s Second Hospital, Lanzhou 730030, Gansu, Chin)

机构地区：[1]兰州大学第二医院儿童医院重症科,甘肃兰州730030 [2]兰州大学第二医院儿童医院消化科,甘肃兰州730030 [3]兰州大学第二医院儿童医院神经科,甘肃兰州730030

出　　处：《临床儿科杂志》2018年第6期456-458,共3页Journal of Clinical Pediatrics

摘　　要：目的探讨儿童脓胸的诊断和治疗。方法回顾分析49例脓胸患儿的临床资料。结果 49例患儿中男25例、女24例,平均年龄(4.7±3.4)岁。常见症状为发热、呼吸急促和咳嗽。血培养阳性11例,胸水培养阳性17例,血和胸水培养均阳性3例;肺炎链球菌是最常见的致病菌。49例患儿均予全身抗生素及胸腔闭式引流,26例加用尿激酶胸膜腔内溶解纤维蛋白治疗,6例手术治疗。预后均良好,无死亡病例。结论儿童脓胸以肺炎链球菌感染最常见;全身抗生素加胸腔闭式引流、尿激酶治疗有效,部分需手术治疗。Objective To explore the diagnosis and treatment of empyema in children. Method The clinical data of empyema in 49 children were reviewed and analyzed. Results In the 49 cases（25 males and 24 females） aged 4.7±3.4 years, the common symptoms were fever, shortness of breath and coughing. There were 11 cases of positive blood culture, 17 cases of positive pleural fluid culture, 3 cases of positive blood and pleural fluid culture. Streptococcus pneumoniae was the most common pathogenic bacteria. All 49 patients were given systemic antibiotics and closed thoracic drainage. In addition, 26 cases were treated with urokinase and intrapleural fibrinolytic therapy and 6 cases were treated surgically. The prognosis was good and there was no death. Conclusion Pneumococcal infection is most common in children with empyema. Systemic antibiotics plus closed thoracic drainage and urokinase are effective, and some require surgical treatment.

关 键 词：脓胸 肺炎链球菌 尿激酶 儿童 

分 类 号：R725.6[医药卫生—儿科]