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頁籤選單縮合
題名 | Hemoptysis in Children=兒童咳血 |
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作者 | 黃健燊; 王超然; 林奏延; | 書刊名 | 長庚醫學 |
卷期 | 21:1 1998.03[民87.03] |
頁次 | 頁57-62 |
分類號 | 417.531 |
關鍵詞 | 兒童咳血; 氣管鏡; 肺部感染; Hemoptysis in children; Bronchoscopy; Pulmonary infections; |
語文 | 英文(English) |
中文摘要 | 背景:兒童期之咳血雖非常見,卻令病童、家長恐懼,也讓兒科醫師倍感困擾。 引起兒童期之咳血原因眾多,早期診斷能夠確實針對治療。 方法:從1994年7月到1996年6月,共有15位咳血病童在長庚兒童醫院胸腔科接受檢查。病 患資料、胸部X光攝影、電腦斷層攝影、晨間胃液作acid fast染色及結核菌培養及消化道 內視鏡檢查,均加以詳細記錄分析。 結果:有6位診斷為肺部感染,其中只有1位為結核病;1例因車禍外傷引起咳血;2例因氣管 切開管損傷黏膜而致咳血;2例為氣管道異物;1例食道出血誤診為咳血;1例肝門靜脈高壓引 起氣管及支氣管充血而導致咳血;2例病人無明顯出血原因,但其中1位於數過後因腸胃道 出血死亡。 結論:兒童期之咳血仍以肺部感染佔最多,唯肺結核卻不常見。氣管鏡之檢查對咳血之診 阿、排除及定位有很大的幫忙,由於小兒咳血之病史不容易正確取得,消化道出血可誤診 為咳血,應小心提防。 |
英文摘要 | Background: Hemoptysis is rare in children, yet is one of the most frightening manifestations of cardiopulmonary disease. A wide spectrum of diseases has been reported to cause hernoptysis in children, but the search for a specific cause can be tedious and unrewarding. Early diagnosis and interventions of hemoptysis are extremely important for the successful management of this potentially lethal process in children. Methods: From July 1994 to June 1996, 15 pediatric patients ranging from 1 month to 15 years of age were admitted to the Pulmonology division for the investigation of hemoptysis. We retrospectively reviewed the clinical records and diagnostic evaluations of these patients. Results: Six (40%) of the patients investigated were infectious in origin, only one patient had tuberculous infection. Three patients had a traumatic cause and 2 patients had foreign bodies in the airway. Two cases had no obvious contributing cause of hemoptysis despite extensive investigations. One patient had hematemesis because bleeding from esophageal ulceration was misinterpreted as hemoptysis. One patient had varicosed tracheal and bronchial collaterals causing massive hemoptysis due to portal vein obstruction and hypertension. Conclusion: Pulmonary infection was the leading cause of hemoptysis in the 15 children we studied, but Mycobacterium tuberculosis is an uncommon causative agent. Bronchoscopy is an extremely useful tool for the diagnosis and localization of hemoptysis. Hematemesis may be mis-interpretated as hemoptysis, particularly when an accurate history is not possible in children, therefore, bleeding from the upper aerodigestive tract should be studied meticulously and excluded adequately, using endoscopy. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。