儿童结核性胸膜炎5例临床分析

发布时间：2018-03-29 13:48

本文选题：结核性胸膜炎　切入点：儿童　出处：《中国实用儿科杂志》2017年03期

【摘要】：目的探讨儿童结核性胸膜炎(TP)的临床特点,提高对该病诊断的准确性。方法回顾性分析天津市儿童医院呼吸二科2015年6月至2016年8月收治的5例临床确诊为结核性胸膜炎患儿的临床资料。结果 5例患儿均经临床表现分析、结核菌素纯蛋白衍生物(TB-PPD)试验、T细胞斑点检测结核感染(T-SPOT)及胸腔积液或血液细菌学检查确诊为TP。经异烟肼、利福平及吡嗪酰胺三联抗痨联合糖皮质激素治疗好转出院。随访3个月,2例15岁患儿胸腔积液吸收好转,遗留胸膜肥厚;1例7岁患儿出现胸壁结核球;1例8岁患儿继发结核性肝脓肿;另1例6岁患儿因包裹性胸腔积液于胸腔镜下行黏连分离术。结论儿童结核性胸膜炎需综合临床表现、结核接触史、病原学检查等多方面因素而确诊,胸腔积液腺苷脱氢酶(ADA)、TB-DNA及血和胸腔积液T-SPOT检测对诊断具有较高的特异性。
[Abstract]:Objective to investigate the clinical characteristics of tuberculous pleurisy in children. Methods the clinical data of 5 children with tuberculous pleurisy from June 2015 to August 2016 were analyzed retrospectively. All of them were analyzed by clinical manifestation. TB-PPD-TB-PPD-TB-PPD-TB-PPD-TB-PPD-TB-PPD-TB-PPD-TB-PPD-TB-PPD-TB-PPD-TB-PPD-TB-PPD-TB-PPD-TB-PPD-TB-PPD-TB-P@@. Rifampicin and pyrazinamide combined with antituberculosis combined with glucocorticoid were cured and discharged. Left pleural hypertrophy in 1 child aged 7 years with tuberculous hepatic abscess secondary to tuberculous liver abscess in 1 case of 8 years of age. Another case of 6 years old was diagnosed by multiple factors such as clinical manifestation, history of tuberculous contact, etiology examination and so on, because encapsulated pleural effusion was separated by thoracoscopic adhesion, conclusion: tuberculous pleurisy in children needs comprehensive clinical manifestation, history of tuberculous contact, etiology examination, and so on. The detection of TB-DNA and T-SPOT in blood and pleural effusion by adenosine dehydrogenase in pleural effusion was highly specific for diagnosis.
【作者单位】：天津市儿童医院呼吸二科;
【基金】：天津市卫计委重点学科攻关项目(13KG125)
【分类号】：R529.3

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