麻疹并气胸或纵隔/皮下气肿12例诊治分析

Analysis of measles complicated with pneumothorax or mediastinal/subcutaneous emphysema in 12 cases

目的探讨麻疹患儿并发气胸或纵隔/皮下气肿的防治措施。方法收集重庆医科大学附属儿童医院1997年1月-2008年12月发生气胸或纵隔/皮下气肿的麻疹住院患儿资料12例进行回顾性分析。结果麻疹患儿并发气胸或纵隔/皮下气肿危险因素包括:缺乏麻疹抗体的保护;剧烈咳嗽;继发耐药细菌感染未有效控制;不恰当的喂药或喂食导致呛咳;小于1岁男婴等。单纯纵隔气肿或少量气胸可保守治疗;引起呼吸困难或张力性气胸可局部穿刺减压,必要时可行胸腔闭式引流。结论早期判断麻疹患儿的气胸/气肿合并症并积极治疗是决定患儿预后的重要因素。

Objective To explore measures of prevention and treatment of children with measles complicated with pneumothorax or mediastinal/subcutaneous emphysema by retrospective analysis. Methods All the 12 children cases of measles with pneumothorax or mediastinal/subcutaneous emphysema hospitalized in Children＇s Hospital of Chongqing Medical Uni- versity during January 1997- December 2008 were reviewed. Results The risk factors include： lack of measles antibody pro- tection; severe coughing; uncontrolled secondary infection of resistant bacteria; choking caused by inappropriate feeding or oral administration. Asfor the treatment, pneumomediastinum alone or a little pneumothorax may be treated conservatively; breathing difficulties caused by pneumomediastinum or tension pneumothorax need puncture decompression; if necessary, closed thoracic drainage should be conducted. Conclusion Diagnosis and appropriate treatment emphysema/ pneumothorax complications in children with measles are important factors in the prognosis.