Munglani R, Kenney I J
Department of Anaesthetics Addenbrookes Hospital, Cambridge, U.K.
Respir Med. 1991 Mar;85(2):117-9. doi: 10.1016/s0954-6111(06)80288-x.
Over a 2-year period, 16 children with parapneumonic effusions were identified at the Royal Alexandra Hospital for Sick Children, Brighton. The case notes of these children were retrospectively reviewed. The presenting symptoms caused diagnostic confusion in two children resulting in negative laparotomies. Isolation of the infecting organism from the parapneumonic group was comparable to other authors, 6 out of 16 patients (53%); however, when the yield from pleural aspirates is compared, there was only one positive culture out of six (17%). Possibilities for improving this disappointing isolation rate are discussed. Two children with the longest history of symptoms and shortest chest drainage time had long term problems. Diagnostic tap, which carries little risk, and drainage, if required, should be performed early.
在两年时间里，布莱顿皇家亚历山德拉儿童医院确诊了16例肺炎旁胸腔积液患儿。对这些患儿的病历进行了回顾性分析。两名患儿的首发症状导致诊断困难，进而进行了阴性剖腹探查术。肺炎旁胸腔积液组感染病原体的分离情况与其他作者的研究结果相当，16例患者中有6例（53%）；然而，当比较胸腔穿刺液的培养阳性率时，6例中只有1例阳性培养结果（17%）。文中讨论了提高这一令人失望的分离率的可能性。两名症状持续时间最长且胸腔引流时间最短的患儿出现了长期问题。诊断性穿刺风险较小，如有需要，应尽早进行引流。
