Shi Yangyi, Li Yan, Hu Yu
Department of Pediatrics, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China.
Front Pediatr. 2025 Jun 5;13:1557273. doi: 10.3389/fped.2025.1557273. eCollection 2025.
The clinical data of a child with complex parapneumonic effusion (PPE) caused by pneumofluke infection were analyzed, and the diagnosis and treatment of the disease were discussed through literature review. The effectiveness and safety of urokinase in the treatment of complex PPE and empyema caused by multiple pathogens were emphasized.
A 3-year-old male child with pneumofluke infection was admitted to the pediatric department of Mianyang Central Hospital. Chest CT and chest ultrasound showed a right pleural effusion with dense septum formation. The condition was relieved after treatment with praziquantel for anti-infection, thoracic catheter drainage, and urokinase injection into pleural cavity. Through systematic literature search of Pubmed, Embase, CNKI, Wanfang and VIP Chinese databases, no cases of urokinase treatment of pleural effusion caused by pneumofluke infection were found.
A total of 150 ml thick yellow turbidous fluid was drained out of the pleural cavity, and the patient's symptoms and signs were significantly relieved. Reexamination of the chest CT showed that the right pleural effusion was significantly reduced and the right lung was significantly reexpanded. There were no complications such as bronchopleural fistula, pneumothorax, abnormal coagulation function, bleeding and fever during treatment.
Thoracic catheter drainage combined with injection of urokinase is an effective and safe method for the treatment of complex PPE and empyema caused by pneumofluke infection in children. At the same time, the literature review showed that urokinase injection into pleural cavity was effective in the treatment of complex PPE and empyema caused by infection, trauma, tumor and other causes, and no obvious side effects occurred.
分析1例肺吸虫感染所致复杂性类肺炎性胸腔积液（PPE）患儿的临床资料，并通过文献复习探讨该病的诊断与治疗，强调尿激酶治疗多种病原体所致复杂性PPE及脓胸的有效性和安全性。
一名3岁男性肺吸虫感染患儿入住绵阳市中心医院儿科。胸部CT和胸部超声显示右侧胸腔积液伴密集分隔形成。经吡喹酮抗感染、胸腔闭式引流及胸腔内注射尿激酶治疗后病情缓解。通过对PubMed、Embase、中国知网、万方和维普中文数据库进行系统文献检索，未发现尿激酶治疗肺吸虫感染所致胸腔积液的病例。
胸腔共引出150 ml浓稠黄色浑浊液体，患者症状和体征明显缓解。胸部CT复查显示右侧胸腔积液明显减少，右肺明显复张。治疗期间未出现支气管胸膜瘘、气胸、凝血功能异常、出血及发热等并发症。
胸腔闭式引流联合尿激酶注射是治疗儿童肺吸虫感染所致复杂性PPE及脓胸的有效且安全的方法。同时，文献复习显示胸腔内注射尿激酶治疗感染、创伤、肿瘤等原因所致复杂性PPE及脓胸有效，且未出现明显副作用。
