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目的 探讨儿童SARS的临床及胸部平片表现特点。方法 回顾 18例按卫生部诊断标准临床诊断为SARS儿童的接触史、主要症状 ,实验室检查结果和胸片表现 ,对照国内外文献进行分析。 18例均有接触史 ,14例为密切接触。主要临床表现为发热、咳嗽、外周血白细胞低 ,其中 5例 <5× 10 9/L ,15例淋巴细胞低。结果 主要胸片X线表现 :( 1) 13例见肺内片状及斑片状实质浸润阴影 ;( 2 ) 3例为类圆形病变 ,边界较清楚 ;( 3 ) 2例磨玻璃样改变 ;( 4 )单侧单发病变多见 ( 10例 ) ,内带较外带略多见 ;( 5)网格状及条点状改变少见 ,未见纵隔、肺门淋巴结肿大及胸腔积液 ;( 6)短时间内病灶变化不如成人快 ,但个别病例病灶呈游走性 ,吸收好转平均 19d。绝大多数病例无后遗改变。结论 儿童SARS的临床表现较成人轻 ,多数有明确接触史 ,X线表现以一侧单发实质浸润病变多见 ,可完全吸收不留后遗症。诊断时需注意与支原体肺炎、腺病毒性肺炎鉴别。
Objective To investigate the clinical features and clinical manifestations of chest X-ray in children with SARS. Methods A retrospective review of 18 cases of SARS children clinically diagnosed according to the diagnostic criteria of contact history, the main symptoms, laboratory findings and chest X-ray findings, the control of domestic and foreign literature analysis. Eighteen patients had history of exposure and 14 were in close contact. The main clinical manifestations of fever, cough, low peripheral white blood cells, 5 cases of <5 × 10 9 / L, 15 cases of low lymphocytes. Results The main radiographs of the chest radiographs were: (1) Thirteen cases were found to have intrapulmonary lamellar and patchy infiltration shadows; (3) 3 cases had roundish lesions with clear border; (3) 2 cases of ground-glass-like changes ; (4) unilateral single lesions more common (10 cases), with a little more than the outer band; (5) grid-like and point-like changes rare, no mediastinal, hilar lymph nodes and pleural volume Liquid; (6) lesions in a short period of time as adults faster, but the individual cases were migratory lesions, absorption improved an average of 19d. The vast majority of cases without any change. Conclusions The clinical manifestations of SARS in children are lighter than those in adults. Most of them have a clear history of exposure. X-ray manifestations are more common in single infiltrative lesions and can be completely absorbed without sequelae. Diagnosis should pay attention to mycoplasma pneumonia, adenovirus pneumonia identification.