CAJ | 학술논문

目的：探讨儿童胸腔积液病因及诊断线索。方法收集1994年1月至2014年1月入院时伴有胸腔积液的患儿2419例，采集临床资料，并分成感染性和非感染性两组进行回顾性分析。结果2419例患儿中男1523例、女896例，平均年龄(6.5±4.0)岁，其中感染组2353例、非感染组66例。感染组较非感染组更易伴有发热，呼吸困难和中到大量积液的发生率低于非感染组(P均<0.01)。感染组中，不同类型感染性胸腔积液的年龄分布差异有统计学意义(P<0.01)，肺吸虫性胸膜炎集中分布于3~7岁(64.0%)，结核性胸膜炎在>7岁发生率较高(53.6%)，而脓胸则好发于≤3岁(51.4%)。感染组的预后明显好于非感染组(P<0.01)。结论儿童胸腔积液以感染为主，病因诊断时需综合考虑发病率、临床表现、积液量等线索，鉴别感染性与非感染性胸腔积液。
목적：탐토인동흉강적액병인급진단선색。방법수집1994년1월지2014년1월입원시반유흉강적액적환인2419례，채집림상자료，병분성감염성화비감염성량조진행회고성분석。결과2419례환인중남1523례、녀896례，평균년령(6.5±4.0)세，기중감염조2353례、비감염조66례。감염조교비감염조경역반유발열，호흡곤난화중도대량적액적발생솔저우비감염조(P균<0.01)。감염조중，불동류형감염성흉강적액적년령분포차이유통계학의의(P<0.01)，폐흡충성흉막염집중분포우3~7세(64.0%)，결핵성흉막염재>7세발생솔교고(53.6%)，이농흉칙호발우≤3세(51.4%)。감염조적예후명현호우비감염조(P<0.01)。결론인동흉강적액이감염위주，병인진단시수종합고필발병솔、림상표현、적액량등선색，감별감염성여비감염성흉강적액。
Objective To investigate the etiology and diagnostic clues of childhood pleural effusion. Methods Two thou-sand four hundred and nineteen hospitalized cases of pleural effusion from Jan. 1994 to Jan. 2014 were included and divided into infection group and non-infection group. Then the clinical data were collected. Results There were 1523 males (63.0%) and 896 females with an average age of 6.5±4.0 years old. There were 2353 cases in the infection group and 66 cases in the non-infection group. The incidence of fever in infection group was much higher than that in non-infection group, whereas the incidence of dys-pnea and moderate-to-large pleural effusion was lower (all P<0.01). There was a signiifcant difference of age distribution among children with different infectious pleural effusion. In infection group, the paragonimus szechuanensis pleurisy occurred preferen-tially in children 3-7 years old, the tuberculous pleurisy occurred preferentially in children>7 years old and the purulent pleurisy occurred preferentially in children ≤3 years old. The prognosis of infection group was much better than that of non-infection group (P<0.01). Conclusions Infection is the predominant cause of childhood pleural effusion. The differential diagnosis from non-infectious pleural effusion should consider the incidence, clinical manifestations and effusion quantity.