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目的 探讨小儿反复肺炎的基础疾病和诊断方法。方法 回顾性分析了 1997年 12月至 2 0 0 2年 12月北京儿童医院 10 6例反复肺炎患儿的临床资料。结果 10 6例反复肺炎患儿中 94例 (88 7% )存在基础疾病 ,其中先天性或获得性呼吸系统解剖异常 4 1例 (43 6 % ) ,呼吸道吸入 15例 (15 9% ) ,先天性心脏病 12例 (12 8% ) ,哮喘 9例 (9 6 % ) ,免疫缺陷病 8例 (8 5 % ) ,原发纤毛不动综合征 5例 (5 3% ) ,特发性肺含铁血黄素沉着症 3例(3 2 % ) ,肺肾综合征 1例 (1 1% )。反复肺炎患儿各种基础疾病各有其病史、体格检查和X线胸片表现特点 ,在此基础上多数基础疾病通过多项检查确诊。结论 儿童反复肺炎多存在基础疾病 ,最常见的是先天性或获得性呼吸系统解剖异常 ,其次为呼吸道吸入、先天性心脏病、哮喘、免疫缺陷病和原发性纤毛不动综合征等。病史、体格检查和X线胸片可以为进一步的检查提供重要线索 ,特殊检查如胸部CT和纤维支气管镜等是多数儿童反复肺炎基础疾病诊断的主要依据。
Objective To investigate the basic diseases and diagnosis of recurrent pneumonia in children. Methods The clinical data of 106 children with recurrent pneumonia in Beijing Children’s Hospital from December 1997 to December 2002 were retrospectively analyzed. Results 94 cases (88.7%) of 106 children with recurrent pneumonia had underlying diseases. Among them, 41 cases (43.6%) had congenital or acquired respiratory abnormalities, 15 cases (15.9%) had respiratory inhalation, Twelve cases (12.8%) had sexual heart disease, 9 cases (9.6%) had asthma, 8 (85%) had immune deficiency disease, 5 cases (53%) had idiopathic cilia syndrome, idiopathic lung There were 3 cases of hemosiderinosis (32%) and 1 case of pulmonary syndrome (11%). Various basic diseases of children with recurrent pneumonia have their own history, physical examination and X-ray findings, based on which most of the basic diseases confirmed by a number of tests. Conclusions There are many underlying diseases of recurrent pneumonia in children, the most common is the abnormality of congenital or acquired respiratory system, followed by respiratory inhalation, congenital heart disease, asthma, immune deficiency disease and primary cilia immobility syndrome. History, physical examination and X-ray can provide important clues for further examination. Special examinations such as chest CT and fiberoptic bronchoscopy are the main bases for the diagnosis of recurrent pneumonia in most children.