儿童特发性间质性肺炎14例的临床特点及诊断分析

Clinical analysis and diagnosis of 14 cases with idiopathic interstitial pneumonia in children

目的探讨儿童特发性间质性肺炎的临床特点和诊断思路。方法回顾性分析14例肺部弥漫性疾病患儿的临床特点以及确诊过程。结果主要症状为进行性呼吸困难伴发绀、干咳、肺底部持续存在细小湿啰音(velcro音)、胸片示两肺广泛性浸润性病变;CT显示:弥漫性肺网状、蜂窝状、磨玻璃状改变。肺功能有限制性通气功能和弥散障碍,血气分析提示低氧血症Ⅰ型呼吸衰竭,以激素和氧疗为主的综合治疗有一定效果。结论IIP的诊断依赖于临床表现、胸片/胸部HRCT、肺功能及血气分析的特征性表现,并除外其它间质性疾病,确诊还需肺活检示IIP病变。

Objective To explore the clinical characteristics, diagnosis for idiopathic interstitial pneumonia （ⅡP） in children. Method A retrospective analysis was held on the pediatric patient＇s clinical materials of 14 eases diagnosed as IIP. Results The main symptoms were progressive dyspnea, eynosis dry cough, fine cracks heard on the base of bilateral lungs, X-ray indicated diffused infiltrative change. High resolution computerized tomography （HRCT） indicated reticulate, honeycomb, frosted. Pulmonary function test was consistent with restrictive impairment and impaired gas exchange. The resting arterial blood gases revealed hypoxemia and respiratory failure. Use of steroids and oxygen was partially effective. Condusfon The diagnosis of IIP in the presence of a surgical biopsy includes the following： clinical symptoms, abnormalities on conventional chest radiographs or HRCT scans, abnormal pulmonary function including evidence of restriction and/or impaired gas exchange and the exclusion of other known causes of interstitial lung disease. The diagnose is based on biopsy examination in lung organization.