摘要
为提高对坏死性肺炎临床表现的认识和诊治成功率,收集2007年8月～2012年7月入住本院经肺组织病理确诊为坏死性肺炎的9例患儿资料,通过分析临床表现、影像学资料、病理和微生物学检查结果,并结合治疗经过和转归,讨论儿童坏死性肺炎的诱因、早期诊断与相关治疗手段。9例患儿(男6例、女3例)年龄1～7岁(平均3.5岁),持续发热11～43d(平均22d)。4例接受机械通气治疗,5例病原学检查为阳性,8例计算机断层扫描(CT)提示肺内出现多发小空洞。9例患儿均存在肺实变伴胸腔积液,病理学诊断为大片肺坏死伴炎性浸润,进行外科手术介入治疗并存活,术后10个月CT提示肺结构恢复正常。结果表明,儿童坏死性肺炎常见病原菌为肺炎链球菌和肺炎支原体;胸部CT扫描结果需结合临床综合判断;坏死性肺炎患儿经积极抗感染及手术治疗预后良好。
In order to build a better understanding of necrotizing pneumonia in children, a retrospective investigation of 9 cases in our hospital was conducted. The clinical manifestations, radiological findings, pathology, microbiology, clinical courses and outcomes of 9 children （6 males, and 3 females） with necrotizing pneumonia were collected and analyzed. The age range was 1-7 years （average 3.5 years）. The duration of fever was 11-43 d （average 22 d）. Four cases received mechanical ventilation. There were 5 cases with microbiological identification, 2 cases with Streptococcus pneumoniae, 2 cases with Mycoplasma pneumoniae and 1 case with Pseudornonas aeruginosa. The chest CT scans showed pneumonic lobar consolidation and pleural effusion in 9 cases, and small cavities in the consolidation regions in 8 cases. All patients received surgical intervention, 7 with wedge resection, I with segmentectomy, and I with lobectomy. All the specimens exhibited parenchymal necrosis and acute inflammatory infiltration. The prognosis is good with antibiotic and surgical therapy. All patients survived. Seven had full clinical recovery within 6 months, and 2 patients had full clinical recovery in 10 months.
出处
《微生物与感染》
2013年第1期33-37,共5页
Journal of Microbes and Infections
关键词
儿童
坏死性肺炎
病原体
诊断
预后
Child
Necrotizing pneumonia
Pathogen
Diagnosis
Prognosis
