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儿童胸膜结核的分隔及相关危险因素

Loculations and Associated Risk Factors of Childhood Pleural Tuberculosis.

作者信息

Wang Jun-Li, Zhou Ming, Zhang Yan-An, Wang Mao-Shui

机构信息

Department of Lab Medicine, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China.

Department of Lab Medicine, Longtan Hospital of Guangxi Zhuang Autonomous Region, Liuzhou, China.

出版信息

Front Pediatr. 2021 Dec 16;9:781042. doi: 10.3389/fped.2021.781042. eCollection 2021.

Abstract

Pleural loculation in childhood pleural tuberculosis (TB) remains a problem in practice, it is usually associated with failure drainage. Therefore, to improve the management of childhood pleural TB, a retrospective study was conducted to identify the risk factors associated with loculated effusion in childhood pleural TB. Between January 2006 and December 2019, consecutive children (≤15 years old) with tuberculous pleural effusion (definite and possible) were included for further analysis. The demographic, clinical, laboratory, and radiographic features were collected from the medical records. Univariate and multivariate logistic regressions were used to explore the factors associated with the presence of pleural loculation in children with pleural TB. A total of 154 children with pleural TB (definite, 123 cases; possible, 31 cases) were included in our study and then were classified as loculated effusion ( = 27) and non-loculated effusion ( = 127) groups by chest X-ray or ultrasonography. Multivariate analysis revealed that male gender (age-adjusted OR = 3.903, 95% CI: 1.201, 12.683), empyema (age-adjusted OR = 4.499, 95% CI: 1.597, 12.673), peripheral monocytes ≤0.46 × 10/L (age-adjusted OR = 4.122, 95% CI: 1.518, 11.193) were associated with the presence of loculated effusion in children with pleural TB. In conclusion, several characteristics, such as male gender, empyema, and peripheral monocyte count have been identified as risk factors for pleural loculation in children with pleural TB. Our findings may be helpful to improve the management of pleural loculation in childhood pleural TB.

摘要

儿童结核性胸膜炎中的胸膜粘连在实际临床中仍是一个问题,它通常与引流失败有关。因此,为了改善儿童结核性胸膜炎的治疗,我们进行了一项回顾性研究,以确定与儿童结核性胸膜炎中包裹性胸腔积液相关的危险因素。在2006年1月至2019年12月期间,纳入连续的(≤15岁)患有结核性胸腔积液(确诊和疑似)的儿童进行进一步分析。从病历中收集人口统计学、临床、实验室和影像学特征。采用单因素和多因素logistic回归分析探讨结核性胸膜炎患儿胸膜粘连的相关因素。本研究共纳入154例结核性胸膜炎患儿(确诊123例,疑似31例),然后根据胸部X线或超声检查分为包裹性胸腔积液组(n = 27)和非包裹性胸腔积液组(n = 127)。多因素分析显示,男性(年龄校正OR = 3.903,95%CI:1.201,12.683)、脓胸(年龄校正OR = 4.499,95%CI:1.597,12.673)、外周血单核细胞≤0.46×10⁹/L(年龄校正OR = 4.122, 95%CI:1.518,11.193)与结核性胸膜炎患儿包裹性胸腔积液的发生有关。总之,男性、脓胸和外周血单核细胞计数等特征已被确定为结核性胸膜炎患儿胸膜粘连的危险因素。我们的研究结果可能有助于改善儿童结核性胸膜炎中胸膜粘连的治疗。

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