21例儿童血性胸腔积液临床分析

Clinical analysis of bloody pleural effusion in 21 cases

摘要:

目的：分析儿童血性胸腔积液（bloody pleural effusion，BPE）的病因及临床特点。方法：回顾性分析2004年6月~2014年5月我科收治的21例儿童BPE的临床表现、辅助检查（B超、CT、胸水常规、生化及培养、骨髓细胞学检查等）及治疗情况。结果：21例儿童BPE中，一般性细菌感染8例，肺炎支原体感染7例，肺吸虫感染3例，结核杆菌感染1例，急性白血病1例，原因不明1例。其中胸水培养仅2例阳性，胸水常规中嗜酸性粒细胞增高3例（37%~61%），支原体PCR阳性4例，骨髓细胞学检查1例阳性（急性白血病），除1例急性白血病及1例原因不明病例预后不详外，其余均治愈出院。结论：儿童BPE仍以感染性疾病多见，其中以细菌及肺炎支原体感染为主，恶性肿瘤少见。

Abstract:

Objective：To analyze the clinical characteristics of children with bloody pleural effusion. Methods：The clinical data of 21 children with bloody pleural effusion from June 2004 to May 2014 were retrospectively analyzed，including clinical manifestations，auxiliary examination（B ultrasound，CT，pleural effusion and bone marrow examination） and the treatments. Results：Among 21 cases，8 cases are caused by bacterial infection，7 caused by mycoplasma pneumoniae infection，3 caused by lung trematode infection，1 caused by tuberculosis infection，1 caused by acute leukemia，and 1 caused by unknown aetiology. There were 2 positive cases in the pleural effusion bacterial culture. The eosinophils of 3 cases were very high （37%~61%），and the mycoplasma PCR of 4 cases were positive in the pleural effusion check. One acute leukemia case was confirmed by bone marrow check. All cases were cured except the acute leukemia case and the case caused by unknown aetiology. Conclusion：Most cases of bloody pleural effusion are caused by in－fection，mainly bacteria infection and mycoplasma pneumoniae infection.