Fabian M C, Smitheringale A
Department of Otolaryngology, Hospital for Sick Children, Toronto, Ontario.
J Otolaryngol. 1996 Feb;25(1):44-5.
Causes of hemoptysis in children have not been well documented in the paediatric otolaryngology literature. The aim of this retrospective review is to determine the commonest causes of hemoptysis in the paediatric age group presenting to an otolaryngologist. We reviewed the charts of patients presenting to an otolaryngologist at The Hospital for Sick Children, Toronto, Ontario, over a 10-year period. A total of 37 inpatients beyond the neonatal period were referred for further assessment of hemoptysis. Thirty-two patients (86.5%) underwent bronchoscopy to determine the cause, the hemoptysis resolving spontaneously in the remaining five patients without a diagnosis. Four patients who had a bronchoscopy also had no identifiable pathology. Tracheobronchitis was the commonest diagnosis (19%), followed by tracheotomy-related problems (15.5%) Other causes included bronchiectasis, aspiration of blood, pulmonary hemorrhage, foreign-body aspiration, cystic fibrosis, A-V malformation, tracheobronchial hemangioma, hereditary telangiectasia, laceration of a vocal cord, and pneumonia. Otolaryngologists need to be aware of the etiology of hemoptysis in children. The commonest causes are infection and trauma, and not vascular anomalies or neoplasms as often perceived.
儿童咯血的病因在儿科耳鼻喉科文献中尚未得到充分记载。本回顾性研究的目的是确定就诊于耳鼻喉科医生的儿童年龄组中咯血的最常见原因。我们回顾了安大略省多伦多市病童医院10年间就诊于耳鼻喉科医生的患者病历。共有37名新生儿期后的住院患者因咯血接受进一步评估。32名患者（86.5%）接受了支气管镜检查以确定病因，其余5名患者咯血自行缓解，未明确诊断。4名接受支气管镜检查的患者也未发现可识别的病变。气管支气管炎是最常见的诊断（19%），其次是气管切开相关问题（15.5%）。其他原因包括支气管扩张、血液吸入、肺出血、异物吸入、囊性纤维化、动静脉畸形、气管支气管血管瘤、遗传性毛细血管扩张、声带撕裂和肺炎。耳鼻喉科医生需要了解儿童咯血的病因。最常见的原因是感染和创伤，而不是通常认为的血管异常或肿瘤。
