| 摘要: |
| 目的:探讨气管性支气管(TB)合并呼吸道感染患儿的临床特征。方法:选取2018 年4 月至2019 年7 月重庆医科大学附
属儿童医院收治的129 例TB 合并呼吸道感染患儿的临床资料进行回顾性分析,同时随访出院后肺炎、喘息、生存等情况。结
果:129 例患儿中,<3 岁婴幼儿占80. 6%,≥3 岁占19. 4%,年龄最大12. 8 岁。81. 4%患儿有持续或反复呼吸道症状,其中咳嗽
持续>4 周占41. 1%,反复/ 持续性喘息占41. 9%,反复肺炎占38. 8%,迁延性肺炎占34. 1%,肺不张占18. 6%。58. 1%患儿合并
其他畸形,其中45. 7%合并呼吸道发育异常,以支气管狭窄为主;39. 5%合并呼吸道外其他系统畸形,以先天性心血管畸形为
主。胸部CT+气道重建及支气管镜检查对TB 均有较高的诊断价值,两者相互补充,更有利于TB 诊断及合并呼吸道感染的治
疗。所有患儿均接受内科常规治疗及支气管肺泡灌洗(BAL)治疗,其中4 例行外科手术,125 例好转出院。共随访91 例患儿,
随访时间3~35 个月,喘息发生率37. 4%,肺炎发生率29. 7%。结论:TB 易合并呼吸道内外畸形。TB 合并呼吸道感染时,其病
程更长、症状更易迁延不愈,可表现为反复/ 持续性呼吸道症状。若临床出现反复/ 持续性呼吸道症状,尤其是婴幼儿患者,需警
惕TB 发育异常,尽早行胸部CT+气道重建或支气管镜检查,以早期诊断TB,避免漏诊。
[关键词]气管性支气管;呼吸道感染;临床特征;儿童 |
| 关键词: 气管性支气管 呼吸道感染 临床特征 儿童 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2023.05.010 |
|
| 基金项目: |
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| Clinical Characteristics Analysis of 129 Children with Tracheal Bronchus and Respiratory Tract Infection |
| Tian Qiao, Peng Donghong |
| (Children’s Hospital of Chongqing Medical University, Ministry of Key Laboratory of Child Development
and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation
Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China) |
| Abstract: |
| Objective: To investigate the clinical characteristics of tracheal bronchus (TB) with respiratory tract infection in children.
Methods: The clinical data of 129 children diagnosed with TB with respiratory tract infection admitted to Children’ s Hospital of
Chongqing Medical University from April 2018 to July 2019 were retrospectively analyzed. The episodes of pneumonia, wheezing and
survival were followed up. Results: Among the 129 children, infants whose age at diagnosis were less than 3 years old accounted for
80. 6%, while patients whose age at diagnosis were no less than 3 years old accounted for 19. 4%. And the maximum diagnostic age was
12. 8 years old. Besides, 81. 4% of the patients showed persistent or recurrent respiratory symptoms, 41. 1% of which had a cough
lasting over 4 weeks, 41. 9% of which had recurrent/ persistent wheezing, 38. 8% of which had recurrent pneumonia, 34. 1% of which
had prolonged pneumonia, and 18. 6% of which had atelectasis. What’ s more, 58. 1% of the patients combined with other
malformations, 45. 7% of which were combined with airway dysplasia, mainly bronchial stenosis; 39. 5% of the patients were combined
with other malformations except the airway dysplasia, mainly congenital cardiovascular malformations. In addition, thoracic CT + airway
reconstruction and bronchoscopy both were of high value for the diagnosis of TB, and it would be more beneficial to the diagnosis of TB
and treatment of TB with respiratory tract infection when they complemented each other. All patients received routine medical treatment
and bronohoalveolar lavage (BAL) during hospitalization, among which 4 cases underwent surgical operations due to other deformities.
Finally, 125 cases were improved and discharged. A total of 91 cases were followed up for 3 to 35 months. The morbidity of wheezing
was 37. 4% and the morbidity of pneumonia was 29. 7%. Conclusion: There is a high possibility that TB associates with other congenital
malformations. When TB is combined with respiratory tract infection, the course of disease may last longer and the infection may be more
prone to delayed healing. Thus, patients with TB can manifest as recurrent/ persistent respiratory symptoms. Clinically, we shall be
aware of TB when recurrent/ persistent respiratory symptoms exist and especially when the patient is an infant aged less than 3 years old,
and thoracic CT and airway reconstruction or bronchoscopy should be performed as soon as possible in order to early diagnose TB and
avoid missed diagnosis. |
| Key words: tracheal bronchus respiratory tract infection clinical characteristic children |
