儿童不明原因咯血实验室诊断案例分析

Laboratory diagnosis of unexplained hemoptysis in children

目的分析1例不明原因咯血患儿的实验室诊断案例,并对儿童咯血的诊疗流程进行探讨。方法回顾性分析本例患儿的临床资料、现病史、既往病史及家族史等。给予患儿包括非侵入性实验室检查、胸部CT及支气管镜检查。结果患儿APTT延长,抗磷脂酰丝氨酸凝血酶原复合物(IgG+IgM)阳性,纤支镜+肺泡灌洗检查显示,右侧肺灌洗液呈黄色,考虑右侧局部出血导致的咯血,考虑右侧肺部小血管畸形的可能性大。结论儿童咯血是一组异质性疾病,病因复杂,采用程序性诊断方法,及时诊断,合理处理,至关重要。

Objective To analyze the laboratory diagnosis of a child with hemoptysis of unknown origin and discuss the diagnosis and treatment of hemoptysis in children.Methods The clinical data,current medical history,past medical history and family history of this case were retrospectively analyzed.The children were given non-invasive laboratory tests,chest CT and bronchoscopy.Results APTT prolonged,anti-phosphoryl serine prothrombin complex(IgG+IgM)positive,fiberoptic bronchoscopy+alveolar lavage examination showed that the right lung lavage fluid was yellow,considering hemoptysis caused by right local hemorrhage,considering the possibility of right pulmonary small vessel malformation.Conclusion Hemoptysis in children is a heterogeneous disease with complicated etiology.It is very important to adopt procedural diagnostic method,diagnose in time and deal with it reasonably.