儿童全身播散性结核病5例临床分析

发布时间：2019-07-02 12:46

【摘要】：目的探讨儿童全身播散性结核病的临床特点、误诊原因及诊治要点。方法收集北京儿童医院2010年7月至2014年9月收治的5例全身播散性结核患儿,分析其临床特点和诊治经过。结果 5例患儿中男2例,女3例,年龄3岁至11岁3个月,病程14~91 d。5例免疫功能均未见异常。起病均急骤,高热,3例伴咳嗽,1例伴腹痛,1例无明显伴随症状,炎症指标升高,外院曾误诊为细菌性肺炎、真菌性肺炎、恶性肿瘤等。2例有结核接触史,3例卡介苗瘢痕(卡疤)阴性。病变累及多脏器系统,包括肺、支气管、胸膜、外周淋巴结、腹膜、腹腔淋巴结、肝、脾、肠、脑膜、脑实质、脑血管、骨骼等,其中肺结核5例,支气管结核1例,结核性胸膜炎1例,腹腔结核4例(其中肝结核1例、脾结核2例、肠结核4例、腹腔淋巴结结核4例、结核性腹膜炎2例),结核性脑膜炎4例,脊柱结核1例,外周淋巴结结核1例。5例患儿抗痨治疗效果好,预后良好。结论儿童全身播散性结核病属重症结核病,起病急骤,炎症指标高,临床表现复杂多样,多脏器受累,临床诊断困难。完善辅助检查,特别是旧结核菌素(PPD)试验、多部位影像学检查、病原学检查,并积极鉴别诊断及临床疗效观察等,对明确诊断有重要作用。
[Abstract]:Objective to investigate the clinical characteristics, causes of misdiagnosis and key points of diagnosis and treatment of systemic disseminated tuberculosis in children. Methods five children with systemic disseminated tuberculosis admitted to Beijing Children's Hospital from July 2010 to September 2014 were collected and their clinical features, diagnosis and treatment were analyzed. Results among the 5 cases, there were 2 males and 3 females, aged from 3 to 11 years and 3 months old. There was no abnormal immune function in 14 鈮，

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