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目的探讨小儿胸腔积液的病因与临床特征。方法回顾性分析上蔡县人民医院儿科1996年1月-2007年6月有明确病因的71例胸腔积液住院患儿的临床资料。结果①71例胸腔积液患儿中以感染为首位原因,其中化脓性感染38例(53.5%),结核感染16例(22.5%),支原体感染9例(12.7%);非感染疾病8例,恶性肿瘤(胸膜间皮瘤)1例,川崎病2例,肾病综合征5例;②44例行胸腔穿刺抽液常规生化检查,符合渗出液改变41例,符合漏出液3例。胸腔积液细胞培养阳性8例,其中肺炎链球菌3例,金黄色葡萄球菌5例,支原体-IgM(+)3例;③胸腔积液原因随不同年龄组有所差异;≤3岁组以化脓性最多见,表现为外周血白细胞明显升高,胸腔积液呈明显化脓性改变,合并肺炎为特征;结核感染中,>7岁儿童多见;在支原体感染中,>3岁儿童较≤3岁儿童多见。结论小儿胸腔积液的病因以感染为主,而感染以化脓、结核、支原体为三大主因,随年龄不同其病因有所不同。
Objective To investigate the etiology and clinical features of pleural effusion in children. Methods The clinical data of 71 patients with pleural effusion hospitalized with definite etiology from January 1996 to June 2007 in Shangcai County People’s Hospital were retrospectively analyzed. Results ① Among the 71 cases of pleural effusion, infection was the primary reason, of which 38 cases (53.5%) were pyogenic infection, 16 cases (22.5%) were tuberculosis infection, 9 cases (12.7%) were mycoplasma infection, 8 cases were noninfectious disease, 1 case of malignant tumor (pleural mesothelioma), 2 cases of Kawasaki disease and 5 cases of nephrotic syndrome. (2) Forty-six routine biochemical tests of thoracentesis were performed, which were consistent with exudate changes in 41 cases and 3 cases of leakage. Pleural effusion cell culture was positive in 8 cases, of which 3 cases of Streptococcus pneumoniae, Staphylococcus aureus in 5 cases, Mycoplasma -IgM (+) in 3 cases; ③ pleural effusion causes with different age groups vary; ≤ 3-year-old group Most purulent, manifested as significantly increased peripheral blood leukocytes, pleural effusion was significantly purulent changes, characterized by pneumonia; tuberculosis infection, more than 7-year-old children; in mycoplasma infection,> 3-year-old children than ≤ 3-year-old child more common. Conclusions The main cause of pleural effusion in children with infection, and infection with suppuration, tuberculosis, mycoplasma are the three main causes of different ages vary.