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目的探讨儿童多浆膜腔积液的临床特点及病因,以提高临床诊治水平。方法回顾性分析2000年1月-2011年6月本院确诊的38例多浆膜腔积液患儿的临床资料,浆膜腔积液标本送检行常规、涂片及细菌培养等检查,采用Light标准判断积液性质。结果本组38例多浆膜腔积液患儿中男24例,女14例;年龄41 d～14岁,其中41 d～3岁8例(21.1%),>3～6岁10例(26.3%),>6～14岁20例(52.6%)。病因以外伤最多见[10例(26.3%)],其次是细菌感染[7例(18.4%)]、肺吸虫病[6例(15.8%)]和心源性疾病[5例(13.2%)]。其中41 d～3岁患儿中外伤最多见,>3～6岁患儿中肺吸虫病多见,>6～14岁患儿以细菌感染为主。多浆膜腔积液以胸腔积液+腹腔积液最多(15例),病因以外伤多见;胸腔积液+心包积液11例,以细菌感染为主;胸腔积液+腹腔积液+心包积液11例,以肺吸虫病多见;心包积液+腹腔积液1例,为高处坠落伤患儿。21例患儿行积液检查,结果显示渗出液16例,其中细菌感染6例,肺吸虫4例,结核病、结缔组织疾病各3例;介于渗出液与漏出液之间5例,渗出液与漏出液为肿瘤及先天性心脏病患儿。肺吸虫病患儿血IgE升高明显,嗜酸性粒细胞均增高。结论儿童多浆膜腔积液好发于6～14岁,以渗出液为主,胸腔积液+腹腔积液最多见;常见病因为外伤、细菌和肺吸虫感染,心源性疾病均为先天性心脏病伴心功能不全;各年龄段的病因构成不同,临床表现无特异性。
Objective To investigate the clinical features and etiology of children with multiple serous effusion to improve the clinical diagnosis and treatment. Methods The clinical data of 38 patients with pleural effusion diagnosed in our hospital from January 2000 to June 2011 were analyzed retrospectively. The specimens of serous effusions were routinely examined, smear and bacterial culture were performed. Light standard to determine the nature of effusion. Results Among the 38 patients with pleural effusion, 24 were male and 14 were female, ranging in age from 41 to 14 years old, of which 8 cases (21.1%) were 41 to 3 years old and 10 cases were> 3-6 years old 26.3%), 20 cases (> 6-14 years old) (52.6%). Followed by bacterial infections (7 cases (18.4%)], paragonimiasis [6 cases (15.8%)] and cardiogenic diseases [5 cases (13.2%)] ]. The most common traumatic injury occurred in children 41 days to 3 years old. Paragonimiasis was more common in children aged 3 to 6 years. Bacterial infections were the most common in children aged 6 to 14 years. Multi-serous effusion to pleural effusion + ascites most (15 cases), the cause of trauma more common; pleural effusion + pericardial effusion in 11 cases, mainly bacterial infections; pleural effusion + ascites + Pericardial effusion in 11 cases, more common to paragonimiasis; pericardial effusion + abdominal fluid in 1 case, for the height of fall injury in children. 21 cases of children underwent fluid examination, the results showed that exudate in 16 cases, of which 6 cases of bacterial infection, paragonimiasis 4 cases, tuberculosis, connective tissue disease in 3 cases; between exudate and leakage of fluid in 5 cases, Exudate and leakage of fluid for children with tumors and congenital heart disease. Paragonimiasis children with elevated blood IgE, eosinophils were increased. Conclusions The majority of children with multiple serous effusion occurred in 6-14 years old, mainly exudate, pleural effusion + ascites most common; common causes of trauma, bacterial and paragonimiasis, cardiac disease are Congenital heart disease with cardiac insufficiency; etiology of different ages constitute a different clinical manifestations.