Yang Kangkang, Dong Lin, Ding Jie, Li Haiyan
Department of Pulmonology, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325027, China.
Zhonghua Er Ke Za Zhi. 2016 Feb;54(2):137-40. doi: 10.3760/cma.j.issn.0578-1310.2016.02.013.
To investigate the etiology and clinical manifestation of hemoptysis in children.
A retrospective analysis was performed for 106 cases of hemoptysis who were admitted to The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University from January 2005 to December 2014.The clinical information including laboratory tests and image data were collected and analyzed.
A total of 106 patients (50 males and 56 females) were identified. The median age was 9.1 years (range 2 months to 18 years). Pneumonia (35, 31.1%) was the most common etiology of hemoptysis, which included bacterial pneumonia (27 cases), mycoplasmal pneumonia(4 cases), chlamydial pneumonia (3 cases), and influenza pneumonia(1 case). Other causes included bronchitis(15, 14.2%), pulmonary tuberculosis (11, 10.4%), bronchiectasis (11, 10.4%), diffuse alveolar hemorrhage (8, 7.5%), idiopathic pulmonary hemosiderosis(6, 5.7%), cardiovascular dysplasia(6, 5.7%), pulmonary contusion (4, 3.8%), foreign body in bronchus (2, 1.9%), allergic bronchopulmonary aspergillosis (2, 1.9%). Eighty-six patients manifested mild hemoptysis; moderate and massive hemoptysis were found in nine and eleven patients, respectively. Pneumonia accounted for 33.7% of mild hemoptysis and 45.5% of massive hemoptysis were due to bronchiectasis; 80.2% were treated with antibiotics and 41.5% were given hemostatic agents; 8.5% received lobectomy. Ninety-six patients (90.6%) were cured and parents gave up treatment in 4 cases (3.8%). Six patients (5.7%) suffered from recurrent hemoptysis.
Hemoptysis mainly occurred in children who were older than 6 years, the most common cause of hemoptysis was respiratory tract infection. In most cases, the amount of hemoptysis was small and the overall prognosis was good.
探讨儿童咯血的病因及临床表现。
对2005年1月至2014年12月在温州医科大学附属第二医院育英儿童医院收治的106例咯血患儿进行回顾性分析。收集并分析包括实验室检查及影像资料在内的临床信息。
共纳入106例患者(男50例,女56例)。中位年龄为9.1岁(范围2个月至18岁)。肺炎(35例,31.1%)是咯血最常见的病因,其中包括细菌性肺炎(27例)、支原体肺炎(4例)、衣原体肺炎(3例)和流感肺炎(1例)。其他病因包括支气管炎(15例,14.2%)、肺结核(11例,10.4%)、支气管扩张症(11例,10.4%)、弥漫性肺泡出血(8例,7.5%)、特发性肺含铁血黄素沉着症(6例,5.7%)、心血管发育异常(6例,5.7%)、肺挫伤(4例,3.8%)、支气管异物(2例,1.9%)、变应性支气管肺曲霉病(2例,1.9%)。86例患者表现为轻度咯血;9例和11例患者分别出现中度和大量咯血。肺炎占轻度咯血的33.7%,大量咯血的45.5%归因于支气管扩张症;80.2%的患者接受了抗生素治疗,41.5%的患者使用了止血剂;8.5%的患者接受了肺叶切除术。96例患者(90.6%)治愈,4例(3.8%)家长放弃治疗。6例患者(