儿童支气管扩张症28例临床分析

目的：探讨儿童支气管扩张症的病因、临床表现、实验室检查及治疗。方法对28例支气管扩张症患儿的病因、临床表现、实验室检查、治疗及转归等进行临床分析。结果儿童支气管扩张症以咳嗽咳痰为主要临床表现，确诊所需时间1个月~8年，病因以感染为主，其次为免疫力异常，胸片检查3例提示局部密度增高影（10.7%），肺部CT均提示支气管扩张。结论支气管扩张症症状不典型，病程迁延，肺部CT检查尤其是高分辨CT检查有利于疾病早期诊断，纤维支气管镜检查对支气管扩张症的诊断作用不大，但可帮助确定有无异物或气道畸形，肺功能检查可提示疾病严重程度。治疗主要是预防并控制感染，经验性治疗可首先考虑大环内酯类，必要时可采用外科手术治疗。

Clinical analysis of 28 children with bronchiectasis

Objective To investigate the etiology, clinical features and the treatment of bronchiectasis in children.Methods To analyze the etiology, clinical symptoms, laboratory examination, treatment and outcome of 28 children with bronchiectasis retrospectively.Results Cough and sputum were the main clinical manifestation in patients. The duration to make a definite diagnosis ranged from 1 month to 8 months. Infection and immunity deficiency was the main cause of the disease. Chest radiography in 3 cases showed local highly density lesion and lung CT suggest bronchiectasis.Conclusion Bronchiectasis had atypical symptoms, prolonged course. Lung CT examination contributed to early diagnosis of disease. Fiberoptic bronchoscopy in the diagnosis is useless, but could help determine whether airway had foreign body or malformations. Pulmonary function tests might indicate the severity of disease. Treatment is focused on the prevention and control of infection, empiric therapy might be considered first macrolide, surgery might be considered when necessary.