儿童胸腔积液2419例病因与诊断线索分析-儿科学专业论文.docxVIP

英汉缩略语名词对照 英文缩写 PE 英文全称 pleural effucion 中文全称 胸腔积液 CT computer tomography 计算机断层成像 CRP C- reaction protein C 反应蛋白 PA prealbumin 前清蛋白 ADA adenosine deaminase 腺苷脱氨酶 1 儿童胸腔积液 2419 例病因分析与诊断线索总结 摘要 目的: 探讨儿童胸腔积液病因及诊断线索。 方法: 回顾性分析 1994 年 1 月至 2014 年 1 月入院时伴有胸腔积液 的 2 419 例患儿，采集临床资料，分感染性和非感染性两组进行分析。 结果: 2 419 例患儿中男 1 523 例、女 896 例，平均年龄（6.5±4.0） 岁，感染组 2 353 例，非感染组 66 例。感染组较非感染组更易伴有发 热，而呼吸困难和中到大量积液的发生率低于非感染组，差异均有统 计学意义（P0.01）；感染组中，不同类型感染性胸腔积液的年龄分布 差异有统计学意义（P0.01），肺吸虫性胸膜炎集中分布于 3~7 岁 （64.0%），结核性胸膜炎在7 岁发生率较高（53.6%），而脓胸则好 发于≤3 岁（51.4%）。感染组的预后明显好于非感染组，差异有统计 学意义（P0.01）。 结论: 儿童胸腔积液以感染为主，在病因诊断时需首先通过综合考 虑发病率、临床表现、积液量等线索与非感染性胸腔积液进行鉴别。 关键词：胸腔积液, 儿童, 病因, 诊断 2 ETIOLOGICAL ANALYSIS AND DIAGNOSTIC CLUES SUMMARY OF 2419 CASES WITH CHILDHOOD PLEURAL EFFUSION ABSTRACT Objective: To investigate the etiology and diagnostic clues of children with pleural effusion. Methods: 2419 hospitalized cases with pleural effusion from Jan. 1994 to Jan. 2014 were included in the study, which were divided into infection group and uninfection group. Then the clinical features were recorded. Results: There were 1523 males (63.0%) and 896 females, with an average age of (6.5±4.0) years old. There were 2353 cases in the infection group and 66 cases in the uninfection group. The frequence of fever in infection group was much higher than that in uninfection group, whereas the frequence of dyspnea and moderate to large amount pleural effusion was lower (all P0.01). Among infection group, the major paragonimus szechuanensis pleurisy were 3~7 years old, whereas most tuberculous pleurisy were 7 years old and the purulent pleurisy were ≤3 years old. However, there was no age character founded in uninfection group. The prognosis of infection group was much better than uninfection group (P0.01). Conclusions: Infection is the predominant cause of childhood pleural effusion. And we should make a differential diagnosis with uninfectious pleural effusion by considering the clues of incidence, clinical manifestations an