论文部分内容阅读
目的总结小儿肺炎旁积液的临床诊疗经验以提高临床诊疗水平。方法对海口市医院儿科2000年1月～2008年12月收治到24例肺炎旁积液的临床表现、实验室检查、治疗及预后进行回顾性分析。结果发病率为10.3%,≤6岁小儿占70.8%。临床表现发热83.3%,咳嗽62.5%,呼吸困难41.7%,,≤6岁小儿更易出现呼吸困难(P<0.05)。实验室检查单纯性肺炎旁积液占70.8%,复杂性或脓胸为29.2%。胸腔积液细菌培养阳性率低,为穿刺送检胸腔液(13例)的23.1%。影像学检查发现右侧积液发生率为最高,占45.8%(左侧、双侧分别为33.3%、20.8%),少量积液为40%(中量及大量分别为35%和25%)。治疗以抗生素保守治疗为主(79.2%),而且以两种抗生素联合应用为多(79.2%)。随访20例无死亡及后遗症发生。结论小儿肺炎旁积液的发病例数有逐年上升的趋势,且多发生于≤6岁的小儿。肺炎旁积液多数无需手术治疗,且预后良好。尽早出台统一规范的肺炎旁积液的诊疗常规以提高临床诊疗水平。
Objective To summarize the experience of clinical diagnosis and treatment of pediatric pneumonia with adjuvant fluid to improve the clinical diagnosis and treatment. Methods The clinical manifestations, laboratory tests, treatment and prognosis of 24 patients with pneumonia paraplegia admitted to Haikou Municipal Hospital from January 2000 to December 2008 were analyzed retrospectively. Results The incidence of 10.3%, ≤ 6 years old children accounted for 70.8%. Clinical manifestations of fever 83.3%, cough 62.5%, dyspnea 41.7%, ≤ 6 years old children are more prone to dyspnea (P <0.05). Laboratory tests were simple pneumonia paracentesis 70.8%, complexity or empyema 29.2%. The positive rate of pleural effusion bacterial culture was low, which was 23.1% of the 13 cases of puncture seized pleural fluid. Radiographic findings revealed the highest incidence of effusion on the right, accounting for 45.8% (33.3%, 20.8% on the left and 33.8% on both sides) and a small amount of effusion (40% and 35%, respectively) . Treatment is dominated by conservative treatment of antibiotics (79.2%), and combined with the two antibiotics (79.2%). No follow-up of 20 cases of death and sequelae occurred. Conclusions The incidence of parainputal fluid in pediatric patients tends to increase year by year, and occurs mostly in children ≤ 6 years old. Pneumonia next to most of the fluid without surgery, and the prognosis is good. Promulgation of a unified norms of routine diagnosis and treatment of pneumonococcal fluid to improve the clinical diagnosis and treatment.