儿童坏死性肺炎诊治进展

• 作 者: 王敏敏
• 机 构: 苏州大学附属儿童医院呼吸科 215003
• 出 处: 国际儿科学杂志
• 发表日期: 2004年期
• 关键词: 坏死性肺炎 儿童 诊断 治疗

儿童坏死性肺炎(necrotizing pneumonia，NP)是儿童社区获得性肺炎的一种严重并发症，近年来，随着儿科医生对儿童坏死性肺炎认识的加深，NP的报道也逐年升高。NP系在肺组织实变的基础上，随着疾病的进展，累及的肺组织出现液化、坏死，最终形成多发囊腔或多发空洞，临床主要依据影像学诊断。既往研究显示NP多见于肺炎链球菌和金黄色葡萄球菌感染，近年来发现肺炎支原体已成为坏死性肺炎的主要病原，腺病毒、流感病毒感染也屡见报道。在合理抗感染治疗的基础上，联合应用糖皮质激素、丙种球蛋白、支气管镜灌洗、胸腔闭式引流等方法，大多数患儿预后良好。“,”Necrotizing pneumonia (NP) is a serious complication of community-acquired pneumonia in children.In recent years, with the deepening understanding of pediatricians, reports on NP have increased year by year.The early lesion of NP is characterized by the consolidation of lung tissue.With the progression of the disease, the involved lung tissue appears liquefaction and necrosis, and eventually multiple cysts or cavities are formed.Clinical diagnosis is mainly based on imaging.Previous studies have shown that NP is mostly found in streptococcus pneumoniae and staphylococcus aureus infections.In recent years, mycoplasma pneumoniae has been found to be the main pathogen of necrotizing pneumonia, and adenovirus and influenza virus infections have also been frequently reported.On the basis of reasonable anti-infection treatment, most of the children have a good prognosis by treatement of glucocorticoid, gamma globulin, bronchoscope lavage, closed thoracic drainage, etc.