��Ѫ����104���ٴ��ع˷���

目的分析儿童咯血病因构成、临床特点及支气管镜表现。方法收集2002年1月至2011年3月于北京儿童医院住院治疗的104例咯血患儿临床资料,分析其临床特点、影像学特点和支气管镜表现,总结儿童咯血的病因构成。结果 104例中特发性肺含铁血黄素沉着症24例、支气管炎29例、肺炎11例、支气管扩张症7例、支气管内膜结核3例、支气管异物5例、支气管动脉肺动脉瘘6例、肺静脉闭塞或缺如3例、疑诊支气管-肺血管发育异常10例(未行血管造影确诊)、肺囊性腺瘤样畸形1例、支气管黏液表皮样癌1例、支气管炎性假瘤1例、韦格纳肉芽肿1例、未分化结缔组织病1例、抗中性粒细胞胞浆抗体(ANCA)相关性小血管炎1例。结论儿童咯血病因复杂,需要结合咯血特点、影像学和支气管镜检查进行诊断和鉴别诊断,急慢性下呼吸道感染、特发性肺含铁血黄素沉着症和先天性支气管肺血管发育异常是引起儿童咯血主要病因。

Clinical retrospective analysis of hemoptysis in 104 children

Objective To analyze the clinical characters , etiology constituent and bronchoscopy manifestation of children with hemoptysis. Methods The study was performed in 104 children diagnosed with hemoptysis during 2002.1～ 2011.3 in Beijing Children ’ s Hospital. According to their clinical characters , radiologic manifestation and bronchoscopy outcome , sum up the etiology constituent of children with hemoptysis. Results In 104 cases , male : female=49 : 55. Idiopathic pulmonary hemosiderosis ( IPH ) 24 cases , bronchiolitis 29 cases , pneumonia 11 cases , bronchiectasis 7 cases , endobronchial tuberculosis 3 cases , foreign body in bronchus 5 cases , bronchial arterial and pulmonary arterial fistula 6 cases , pulmonary vein obstruction or agenesis 3 cases , suspicious of bronchial pulmonary vessel dysplasia 10 cases ( requiring angiogram ), congenital cystic adenomatoid malformation ( CCAM ) of lung 1 case , bronchial inflammatory pseudotumor 1case , tumor of bronchus 1 case , Wegener granulomatosis 1 case , undifferentiated connective tissue disease 1 case , resistant ANCA small vessel vasculitis 1case. Conclusion In conclusion , acute or chronic low airway infections , idiopathic pulmonary hemosiderosis ( IPH ) and congenital branch pulmonary vessels dysplasia are the first three etiology of hemoptysis in children.