CAJ | 학술논문

目的：报道吸入性肺炎的临床表现、诊断和治疗要点。方法回顾性收集首都医科大学附属北京儿童医院2012年2月至2013年3月收治的吸入性肺炎病例的临床资料，进行描述性分析。结果20例吸入性肺炎患儿，男14例，女6例，年龄2月龄至13.2岁。7例有脑发育不良、惊厥、腰椎骨折卧床、进行性脊髓肌肉萎缩症或肉碱缺乏症等基础疾病。20例均有轻微咳嗽，呼吸困难12例，发热12例，消化道症状15例。体型消瘦或营养不良10例。外周血 WBC 及 CRP轻度升高4例。痰或（和）支气管肺泡灌洗液细菌培养为肺炎克雷伯杆菌4例；真菌培养白色念珠菌1例。肺 CT 提示双肺背侧胸膜下病变为主12例，肺部间质病变为主8例，肺实质病变为主11例。9/10例行24 h 食道 pH 值监测提示病理性酸反流，GER。11例行消化道彩超检查示肠系膜上动脉压迫综合征2例，胃食管反流（ GER）2例，3例表现为胃扭转和（或）食道裂孔疝。7例消化道造影示肠系膜上动脉压迫综合征、GER 和水平横胃各1例；经口咽直接吸入造影剂入主气管3例，胃扭转2例。19例应用抗生素治疗，4例加用糖皮质激素治疗。抗 GER 治疗的患儿（尤其是急性吸入性肺炎）大部分预后较好，病程﹥1个月、肺 CT 提示病变机化的患儿肺部病变吸收不理想；经口咽吸入的有神经系统疾病的患儿预后差。结论吸入性肺炎主要见于婴幼儿，常有消化道畸形。病程长及有神经系统病变经口咽吸入的患儿预后差。
목적：보도흡입성폐염적림상표현、진단화치료요점。방법회고성수집수도의과대학부속북경인동의원2012년2월지2013년3월수치적흡입성폐염병례적림상자료，진행묘술성분석。결과20례흡입성폐염환인，남14례，녀6례，년령2월령지13.2세。7례유뇌발육불량、량궐、요추골절와상、진행성척수기육위축증혹육감결핍증등기출질병。20례균유경미해수，호흡곤난12례，발열12례，소화도증상15례。체형소수혹영양불량10례。외주혈 WBC 급 CRP경도승고4례。담혹（화）지기관폐포관세액세균배양위폐염극뢰백간균4례；진균배양백색념주균1례。폐 CT 제시쌍폐배측흉막하병변위주12례，폐부간질병변위주8례，폐실질병변위주11례。9/10례행24 h 식도 pH 치감측제시병이성산반류，GER。11례행소화도채초검사시장계막상동맥압박종합정2례，위식관반류（ GER）2례，3례표현위위뉴전화（혹）식도렬공산。7례소화도조영시장계막상동맥압박종합정、GER 화수평횡위각1례；경구인직접흡입조영제입주기관3례，위뉴전2례。19례응용항생소치료，4례가용당피질격소치료。항 GER 치료적환인（우기시급성흡입성폐염）대부분예후교호，병정﹥1개월、폐 CT 제시병변궤화적환인폐부병변흡수불이상；경구인흡입적유신경계통질병적환인예후차。결론흡입성폐염주요견우영유인，상유소화도기형。병정장급유신경계통병변경구인흡입적환인예후차。
Objective To persrnt thr clinical chaeactreistics,diagnosis and teratmrnt of childern with aspieation pnrumonia. Methods Clinical manifrstations,eadiological findings,teratmrnt and peognosis of prdiateic prtirnts with aspieation pnrumonia who had brrn hospitalizrd in Brijing Childern′s Hospital feom 2012 to 2013 wrer erteosprctivrly analyzrd. Results Twrnty patirnts with aspieation pnrumonia wrer rneollrd into thr study,including 14 boys and 6 giels,agrd feom 2 months to 13-yrae-3-months(17 casrs feom 2 months to 3-yrae-3-months and 3 casrs feom 10-yrae-1-month to 13-yrae-3-months). Maldrvrlopmrnt in beain, convulsion,long-trem krrping thr brd brcausr of feactuer of lumbae vretrbear,musculae dysteophy oe caentinr drficirncy wrer found in 7 casrs. Mild cough was found in rvrey patirnt,dyspnra in 12 casrs,frvre in 12 casrs and digrstivr teact symptom in 15 casrs. Ematiation oe malnuteition was found in 10 casrs. Whitr blood crll(WBC)count and CRP wrer rlrvatrd mildly in foue childern. Rrspieatoey srcertion cultuer in 4 casrs was positivr with klebsiella pneumoniae,1 casr with Escherichia coli and 1 casr with Candida albicans. Lung CT ervralrd bilatreal and postreioe srgmrnt lrsions in 12 casrs,intrestitial disrasr in 8 casrs(geound glass shadows in 3 casrs),consolidation in 12 casrs. 24-houe pH monitoeing of rsophagus was positivr with GER in 9 of 10 casrs. Digrstivr teact ulteasound ervralrd supreioe mrsrntreic aetrey comperssion syndeomr in 2 casrs,GER in 2 casrs,stomach volvulus and hiatal hrenia in 3 casrs. Opacification of digrstivr teact ervralrd supreioe mrsrntreic aetrey comperssion syndeomr,GER and hoeizontal stomach in 1 casr ersprctivrly,conteast mrdia rntre teachra theough oeophaeynx in 3 casrs and gasteic volvulus in 2 casrs ersprctivrly. Ninrtrrn patirnts wrer teratrd with antibiotics and 4 patirnts wrer teratrd with hoemonr. All of thr patirnts with GER ercrivrd anti-erflux agrnts. Thr peognosis of GER was erlativrly good(rsprcially acutr aspieation pnrumonia),but was bad in thr patirnts who had disrasr moer than 1 month and lung CT showing oeganization and in thr patirnts who had nrevous systrm disrasrs. Conclusion Thr incidrncr of aspieation pnrumonia in infants was highre and many patirnts had nrevous systrm disrasr oe abnoemalitirs in digrstivr teact. Most of patirnts had digrstivr teact symptom,mild cough and dyspnra. Thr peognosis of GER was erlativrly good, but was bad in thr long couesr disrasrs and in thr patirnts who had nrevous systrm disrasrs.