支气管扩张症38例临床特征

目的探讨儿童支气管扩张症的临床特点,为其早期诊断和及时治疗提供依据。方法收集复旦大学附属儿科医院1992年1月-2008年12月收治的38例支气管扩张症患儿(男21例,女17例;年龄4个月～15岁)的临床资料,从其病因、临床表现、肺功能、影像学检查及治疗等方面进行分析。结果支气管扩张症38例病因包括感染性因素27例(71.1%),免疫缺陷病3例(7.9%),支气管异物、先天性因素各2例(各5.3%),肺隔离症1例(2.6%),其他4例(10.5%)。临床表现为长期咳嗽38例(100%),咳痰30例(78.9%),咯血18例(47.4%)。影像学以胸部CT为依据,其中呈囊状、囊泡状改变29例(76.3%),柱状改变3例(7.9%),2种改变同时存在6例(15.8%)。结论儿童时期的肺部感染是支气管扩张症常见病因,特别是结核、麻疹及重症细菌性感染,而常见变异型免疫缺陷病患儿有发生支气管扩张症的危险。肺功能检查是评价支气管扩张症患者病变严重程度的重要手段。支气管扩张症的治疗应重在预防,对于反复肺部感染的患儿,有必要行高分辨率CT检查,以利于早期诊治。

Clinical Characteristics of Bronchiectasis in 38 Children

Objective To investigate the clinical characteristics of bronchiectasis in children and provide clues for early diagnosis and treatment of the disease.Methods The clinical records of 38 bronchiectasis patients(21 male,17 female;aged 4 months to 15 years old) were reviewed and analyzed the etiology,clinical characteristics,pulmonary function,imaging data and treatment of the disease.Results In the 38 bronchiectasis children,etiological factors included infection(27/38 cases,71.1%),immune deficiency(3/38 case...