Gurkan Bozan, Eylem Kiral, Mahmut Can Kizil, Yalçın Kara, M. Arda, Huseyin ILHAN, TURKEY, Çiğdem Öztunali, Tercan Us, Ömer Kılıç, Ener Çağrı Dinleyici
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目的:胸腔积液是细菌性肺炎的一种并发症,由于其在儿童中的发病率和死亡率很高,因此尤为重要。本研究的目的是探讨儿童胸腔积液的临床和病因。材料-方法:回顾性分析2012年1月至2022年12月在eskiehir Osmangazi大学医学院随访的胸腔积液患儿病历。临床和病因特征,实验室和放射学结果,以及治疗方案。结果:记录了59例7 ~ 216月龄儿童(中位100月龄)的病历,其中女孩占55.9%。胸腔积液的病因为肺旁积液37例(62.7%),结核性胸膜炎8例(13.5%)。最常见的细菌病原体是化脓性链球菌、结核分枝杆菌、铜绿假单胞菌、肺炎链球菌和流感嗜血杆菌。在大流行后时期,虽然结核性胸膜炎的病例有所减少,但由于化脓性链球菌引起的胸腔积液却有所增加。单纯内科治疗占39%,插管开胸占55%,开胸加去皮占18.6%。45.8%的儿童需要在儿科重症监护病房住院。平均住院时间为12天。结论:细菌引起的肺旁积液是儿童胸腔积液最常见的原因。2019冠状病毒病大流行后,结核性胸膜炎的发病率虽有所下降,但化脓性链球菌所致胸腔积液/脓胸的发病率有所上升。
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Plevral Efüzyonla Hastaneye Yatan Çocukların Epidemiyolojik Ve Klinik Profili: Tek Merkez Deneyimi 2012-2022
Objective: Pleural effusion is a complication of bacterial pneumonia that is of particular importance because of its significant morbidity and mortality in children. The aim of this study was to investigate the clinical and etiological profile of pleural effusion in children. Materials-Methods: Medical records of children with pleural effusion who were followed up at Eskişehir Osmangazi University Faculty of Medicine between January 2012 and December 2022 were retrospectively evaluated. Clinical and etiological features, laboratory and radiological results, and treatment regimens of were noted. Results: Medical records of 59 children (55.9% girls) aged between 7 to 216 months (median 100 months) have been noted. The etiology of pleural effusion was parapneumonic effusion in 37 children (62.7%), tuberculous pleurisy in eight children (13.5%). The most common bacterial pathogens were Streptococcus pyogenes, Mycobacterium tuberculosis, Pseudomonas aeruginosa, Streptococcus pneumoniae and Haemophilus influenzae. In the post-pandemic period, while cases of tuberculous pleurisy are decreasing, there is an increase in pleural effusions due to Streptococcus pyogenes. Medical treatment alone was given in 39% of cases, tube thoracostomy in 55%, thoracotomy and decortication in 18.6%. A 45.8% of children required pediatric intensive care unit stay. The median hospital stay was 12 days. Conclusion: Parapneumonic effusions due to bacterial agents are the most common cause of pediatric pleural effusions. After the COVID-19 pandemic, while cases of tuberculosis pleurisy are decreasing, there is an increase in Streptococcus pyogenes-induced pleural effusion/empyema.
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