中华儿科杂志
中華兒科雜誌
중화인과잡지
Chinese Journal of Pediatrics
2014年
3期
205-208
,共4页
革丽莎%陈泗虎%林苗苗%夏小娇%金益梅%何时军
革麗莎%陳泗虎%林苗苗%夏小嬌%金益梅%何時軍
혁려사%진사호%림묘묘%하소교%금익매%하시군
矿物油%肺炎,吸入性%儿童
礦物油%肺炎,吸入性%兒童
광물유%폐염,흡입성%인동
Mineral oil%Pneumonia,aspiration%Child
目的 探讨儿童油脂吸入性肺炎的临床特点及影像学表现.方法 对2003年1月至2013年7月温州医科大学附属育英儿童医院收治的住院确诊的16例油脂吸入性肺炎患儿的临床资料、影像学特点及治疗、转归进行回顾性分析.结果 16例患儿均有明确的矿物油误服史.4例无任何临床表现;10例出现发热,其中8例于误服矿物油后4～8h内出现,体温均39.0 ～ 40℃;12例有症状患儿在误服30 min内出现喘息2例,气促6例,发绀l例,呼吸困难3例,呻吟不安2例;伴发胸痛l例,头痛伴脑电图异常1例;体格检查闻及肺部哕音6例.血常规示白细胞增多10例,C-反应蛋白升高7例.6例患儿于误服后24 h内行胸部CT检查均发现异常,最早见于误服后2 h;9例行胸部X线片均发现异常,最早见于误服后3h;1例于误服后2～3h胸部X线片未见异常,3d后复查异常.所有患儿均接受糖皮质激素及抗生素治疗,4例接受了肺泡灌洗,3例输注白蛋白针,6例输注丙种球蛋白针.其中有3例患儿诊断及激素治疗延误,出现病情加重,2例明确继发感染.最终12例患儿肺部达到基本或完全吸收,历时8d～5.5个月.结论 儿童油脂吸入性肺炎多见于误服矿物油后.大多数患儿在吸入24h内均能出现肺部影像学改变,早期行胸部CT检查有助于诊断.激素治疗能加快病变吸收.
目的 探討兒童油脂吸入性肺炎的臨床特點及影像學錶現.方法 對2003年1月至2013年7月溫州醫科大學附屬育英兒童醫院收治的住院確診的16例油脂吸入性肺炎患兒的臨床資料、影像學特點及治療、轉歸進行迴顧性分析.結果 16例患兒均有明確的礦物油誤服史.4例無任何臨床錶現;10例齣現髮熱,其中8例于誤服礦物油後4～8h內齣現,體溫均39.0 ～ 40℃;12例有癥狀患兒在誤服30 min內齣現喘息2例,氣促6例,髮紺l例,呼吸睏難3例,呻吟不安2例;伴髮胸痛l例,頭痛伴腦電圖異常1例;體格檢查聞及肺部噦音6例.血常規示白細胞增多10例,C-反應蛋白升高7例.6例患兒于誤服後24 h內行胸部CT檢查均髮現異常,最早見于誤服後2 h;9例行胸部X線片均髮現異常,最早見于誤服後3h;1例于誤服後2～3h胸部X線片未見異常,3d後複查異常.所有患兒均接受糖皮質激素及抗生素治療,4例接受瞭肺泡灌洗,3例輸註白蛋白針,6例輸註丙種毬蛋白針.其中有3例患兒診斷及激素治療延誤,齣現病情加重,2例明確繼髮感染.最終12例患兒肺部達到基本或完全吸收,歷時8d～5.5箇月.結論 兒童油脂吸入性肺炎多見于誤服礦物油後.大多數患兒在吸入24h內均能齣現肺部影像學改變,早期行胸部CT檢查有助于診斷.激素治療能加快病變吸收.
목적 탐토인동유지흡입성폐염적림상특점급영상학표현.방법 대2003년1월지2013년7월온주의과대학부속육영인동의원수치적주원학진적16례유지흡입성폐염환인적림상자료、영상학특점급치료、전귀진행회고성분석.결과 16례환인균유명학적광물유오복사.4례무임하림상표현;10례출현발열,기중8례우오복광물유후4～8h내출현,체온균39.0 ～ 40℃;12례유증상환인재오복30 min내출현천식2례,기촉6례,발감l례,호흡곤난3례,신음불안2례;반발흉통l례,두통반뇌전도이상1례;체격검사문급폐부홰음6례.혈상규시백세포증다10례,C-반응단백승고7례.6례환인우오복후24 h내행흉부CT검사균발현이상,최조견우오복후2 h;9례행흉부X선편균발현이상,최조견우오복후3h;1례우오복후2～3h흉부X선편미견이상,3d후복사이상.소유환인균접수당피질격소급항생소치료,4례접수료폐포관세,3례수주백단백침,6례수주병충구단백침.기중유3례환인진단급격소치료연오,출현병정가중,2례명학계발감염.최종12례환인폐부체도기본혹완전흡수,력시8d～5.5개월.결론 인동유지흡입성폐염다견우오복광물유후.대다수환인재흡입24h내균능출현폐부영상학개변,조기행흉부CT검사유조우진단.격소치료능가쾌병변흡수.
Objective To investigate clinical characteristics and changes of pulmonary imaging of mineral oil aspiration pneumonia in children.Method The clinical features,CT findings,and effects of corticosteroid therapy were analyzed in 16 children with mineral oil aspiration pneumonia,who were hospitalized in our hospital from January 2003 to July 2013.Result All patients with mineral oil aspiration pneumonia had a history of mineral oil administration.Four patients had no clinical manifestations.Ten cases presented fever,and 8 of the 10 patients had fever in 4-8 h after taking mineral oil,and the temperature was between 39-40 ℃.There were wheezing in 2 cases,shortness of breath in 6 cases,cyanosis in 1 case,dyspnea in 3 cases,and moaning in 2 cases,chest pain in 1 case,headache and abnormal EEG in 1 case.Six patients had rales in lungs.Peripheral blood white cells increased in 10 cases,and C-reactive protein elevated in 7 patients.Chest CT examination showed abnormal findings in 6 children,and the earliest CT was performed within 2 h after the accident.The rest 10 children got chest X-ray,and 9 of 10 children had abnormal findings.The earliest X-ray was done within 3 h after the accident.And the remaining 1 of 10 children showed no significant changes in the first chest X-ray 2-3 h after the accident until 3 days.All of the patients received corticosteroid and antibiotic treatments,4 cases underwent bronchoalveolar lavage,3 patients were given albumin,6 cases received intravenous immunoglobulin.Three cases delayed in treatment with hormone because of misdiagnosis,and 2 of them had clearly secondary infections.Twelve patients recovered completely from oil aspiration pneumonia after 8 days to 5.5 months.Conclusion Oil aspiration pneumonia in children occurs in almost all cases after mineral oil aspiration.Pulmonary opacities can be found by chest CT in most patients within 24 hours after mineral oil aspiration.Corticosteroids therapy was effective for patients with exogenous lipid pneumonia,which may inhibit the inflammatory response and possible pulmonary fibrosis.
