摘要
目的:探讨气管性支气管(TB)合并呼吸道感染患儿的临床特征。方法:选取2018年4月至2019年7月重庆医科大学附属儿童医院收治的129例TB合并呼吸道感染患儿的临床资料进行回顾性分析,同时随访出院后肺炎、喘息、生存等情况。结果:129例患儿中,<3岁婴幼儿占80.6%,≥3岁占19.4%,年龄最大12.8岁。81.4%患儿有持续或反复呼吸道症状,其中咳嗽持续>4周占41.1%,反复/持续性喘息占41.9%,反复肺炎占38.8%,迁延性肺炎占34.1%,肺不张占18.6%。58.1%患儿合并其他畸形,其中45.7%合并呼吸道发育异常,以支气管狭窄为主;39.5%合并呼吸道外其他系统畸形,以先天性心血管畸形为主。胸部CT+气道重建及支气管镜检查对TB均有较高的诊断价值,两者相互补充,更有利于TB诊断及合并呼吸道感染的治疗。所有患儿均接受内科常规治疗及支气管肺泡灌洗(BAL)治疗,其中4例行外科手术,125例好转出院。共随访91例患儿,随访时间3~35个月,喘息发生率37.4%,肺炎发生率29.7%。结论:TB易合并呼吸道内外畸形。TB合并呼吸道感染时,其病程更长、症状更易迁延不愈,可表现为反复/持续性呼吸道症状。若临床出现反复/持续性呼吸道症状,尤其是婴幼儿患者,需警惕TB发育异常,尽早行胸部CT+气道重建或支气管镜检查,以早期诊断TB,避免漏诊。
Objective:To investigate the clinical characteristics of tracheal bronchus(TB)with respiratory tract infection in children.Methods:The clinical data of 129 children diagnosed with TB with respiratory tract infection admitted to Children’s Hospital of Chongqing Medical University from April 2018 to July 2019 were retrospectively analyzed.The episodes of pneumonia,wheezing and survival were followed up.Results:Among the 129 children,infants whose age at diagnosis were less than 3 years old accounted for 80.6%,while patients whose age at diagnosis were no less than 3 years old accounted for 19.4%.And the maximum diagnostic age was 12.8 years old.Besides,81.4%of the patients showed persistent or recurrent respiratory symptoms,41.1%of which had a cough lasting over 4 weeks,41.9%of which had recurrent/persistent wheezing,38.8%of which had recurrent pneumonia,34.1%of which had prolonged pneumonia,and 18.6%of which had atelectasis.What’s more,58.1%of the patients combined with other malformations,45.7%of which were combined with airway dysplasia,mainly bronchial stenosis;39.5%of the patients were combined with other malformations except the airway dysplasia,mainly congenital cardiovascular malformations.In addition,thoracic CT+airway reconstruction and bronchoscopy both were of high value for the diagnosis of TB,and it would be more beneficial to the diagnosis of TB and treatment of TB with respiratory tract infection when they complemented each other.All patients received routine medical treatment and bronohoalveolar lavage(BAL)during hospitalization,among which 4 cases underwent surgical operations due to other deformities.Finally,125 cases were improved and discharged.A total of 91 cases were followed up for 3 to 35 months.The morbidity of wheezing was 37.4%and the morbidity of pneumonia was 29.7%.Conclusion:There is a high possibility that TB associates with other congenital malformations.When TB is combined with respiratory tract infection,the course of disease may last longer and the infection may be more prone to delayed healing.Thus,patients with TB can manifest as recurrent/persistent respiratory symptoms.Clinically,we shall be aware of TB when recurrent/persistent respiratory symptoms exist and especially when the patient is an infant aged less than 3 years old,and thoracic CT and airway reconstruction or bronchoscopy should be performed as soon as possible in order to early diagnose TB and avoid missed diagnosis.
作者
田巧
彭东红
Tian Qiao;Peng Donghong(Children’s Hospital of Chongqing Medical University,Ministry of Key Laboratory of Child Development and Disorders,National Clinical Research Center for Child Health and Disorders,China International Science and Technology Cooperation Base of Child Development and Critical Disorders,Chongqing Key Laboratory of Pediatrics,Chongqing 400014,China)
出处
《儿科药学杂志》
CAS
2023年第5期34-38,共5页
Journal of Pediatric Pharmacy
关键词
气管性支气管
呼吸道感染
临床特征
儿童
tracheal bronchus
respiratory tract infection
clinical characteristic
children
