儿童结核性胸腔积液诊断与治疗

Diagnosis and treatment of tuberculous pleural effusion in children

结核性胸腔积液的发病主要由胸膜对结核蛋白的迟发型超敏反应所致。诊断主要根据患儿年龄、临床表现和胸部影像特征,结合结核接触史及结核菌素试验、胸腔积液分析和微生物学检查等结果进行综合判断。治疗以抗结核药物为主,对于大量结核性胸腔积液应给予治疗性胸腔穿刺,并可加用激素治疗。

The pathogenesis of tuberculous pleural effusion （TPE） is mainly due to pleural delayed hypersensitivity to my- cobacterial protein. The diagnosis of TPE is largely based on age, clinical manifestations, chest imaging features, a history of contact with tuberculosis, tuberculin skin test, pleural fluid analysis and microbiology. The treatment of TPE is mainly through the use of antitubereulous drugs. Therapeutic thoracen- tesis should be used and corticosteroids can be added for mas- sive tuberculous pleural effusion.