■这项研究的目的是分析由流感嗜血杆菌引起的急性脓胸儿童的临床资料,并通过文献复习探讨本病的诊断和治疗方法,以提高临床对本病的认识。
■杭州师范大学附属医院儿科收治一名6岁女性急性流感嗜血杆菌脓胸,杭州,中国。胸膜穿刺液原来是黄色浑浊脓液,根据胸腔积液的分类诊断为脓胸。高通量测序显示流感嗜血杆菌的存在。经过综合治疗,包括抗生素,闭式胸腔引流,胸膜内注射尿激酶,胸腔积液被吸收和排出。Pubmed中的系统文献检索,Embase,Scopus,CNKI,万方,和VIP中文数据库显示,没有一例由H型流感引起并接受尿激酶治疗的儿童急性脓胸。
■治疗期间无支气管胸膜瘘和张力性气胸。出院后一个月,胸部计算机断层扫描(CT)显示胸膜无增厚,肺功能正常。
■儿童肺炎在症状初步改善后恶化,这是一个需要进一步医疗护理的问题。胸腔积液病原体高通量测序可提高检出率。本研究表明,胸腔闭式引流联合胸膜腔内注射尿激酶是治疗儿童流感嗜血杆菌脓胸的有效方法。
UNASSIGNED: The purpose of this study is to analyze the clinical data of a child with acute empyema caused by Haemophilus influenzae, and to investigate the diagnosis and treatment of this disease through literature
review to improve the clinical understanding of this kind of disease.
UNASSIGNED: A 6-year-old female with acute H. influenzae empyema was treated at the Department of Pediatrics of The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China. The pleural puncture fluid turned out to be yellow turbid pus, and the pleural effusion was diagnosed as empyema according to the classification of pleural effusions. High-throughput sequencing revealed the presence of H. influenzae. After comprehensive treatment, including antibiotics, closed pleural drainage, and intrapleural injection of urokinase, the pleural effusion was absorbed and discharged. A systematic literature search in Pubmed, Embase, Scopus, CNKI, Wanfang, and VIP Chinese databases revealed no cases of acute empyema in children caused by H. influenza and treated with urokinase.
UNASSIGNED: There was no bronchopleural fistula and tension pneumothorax during the treatment. One month after discharge, chest computed tomography (CT) revealed no pleural thickening and normal pulmonary function.
UNASSIGNED: Pneumonia in the child worsened after an initial improvement of symptoms, which is an issue that requires further medical attention. High-throughput sequencing of pathogens in pleural effusion can improve the detection rate. This study indicated that closed pleural drainage combined with intrapleural injection of urokinase is an effective treatment for H. influenzae empyema in children.