MSCT诊断小儿脓胸及对临床治疗方式选择的指导意义

Diagnosing Pediatric Empyema with MSCT and its Implicatio for Clinical Treatment Options

目的:探讨多层螺旋CT(MSCT)对小儿脓胸的诊断及对临床治疗方案选择的指导意义,从而达到消除脓腔及感染,促进肺复张的治疗目的。方法:选择2008年3月至2011年12月在我院行MSCT检查并经三维重建的病历资料完整的小儿脓胸患儿36例为研究对象,进行回顾性分析。结果:本组患儿左侧脓胸19例,右侧脓胸15例,脓气胸2例。合并肺脓肿14例,少量积液9例,中量积液17例,大量积液10例。对渗出早期、少量胸腔积液的脓胸患儿9例给予抗菌素治疗及支持治疗,其中3例治疗效果不佳,改行胸腔抽脓治疗;纤维脓性期18例行胸腔引流冲洗、胸腔闭式引流;对慢性期(机化期)脓胸患儿9例行手术治疗。结论:根据MSCT不同分期而对小儿脓胸采取适当的治疗方法,能有效缩短感染及脓腔存在的时间及病程。

Objective： To explore the value of diagnosing pediatric empyema with Multi-slice Spiral CT（MSCT）,and discuss its implications for providing clinical treatment options,eliminating infection,and recovering pulmonary function.Methods：From March 2008 untill December 2011,a total of 36 pediatric patients with empyema diagnosed through MSCT,and with full clinical data were chosen for a retrospective analysis.Results：19 patients had empyema on the left side,15 patients had emyema on the right side.Empyema complicated with pneumothorax was observed in 2 patients,while 14 patients had a concominant lung abscess.9,17,and 10 patients had small,intermediate and large amounts of empyema respectively.9 children with early stage and small amount of empyema was treated with antibiotics,with 3 of them resort to pulmonary puncture after treatment failure.18 patients with fibrosis received pleural drainage and closes thoracic drainage.9 patients with chronic organized stage were given surgical treatment.Conclusion：Treatment were given according to different stages in MSCT can effectively shorten the time with infection and abscess.