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儿童细菌性气管炎的临床特征及诊断

Author
Charles R Woods, MD, MS
Section Editors
Glenn C Isaacson, MD, FAAP
Sheldon L Kaplan, MD
Deputy Editor
Carrie Armsby, MD, MPH
Translators
杨晓蕴, 主任医师

引言

儿童细菌性气管炎的临床特征和诊断将总结在此。儿童细菌性气管炎的治疗，以及儿童气管造口导管和气管插管相关的气管感染将单独讨论。 (参见“儿童细菌性气管炎：治疗和预防”和“儿童气管造口导管和气管插管相关的气管支气管炎”)

术语

细菌性气管炎是气管软组织的一种侵袭性、渗出性细菌感染(图片 1)[1]，有时存在声门下喉结构受累、扩展至上支气管树或合并有肺炎[2-5]。因此，该疾病更准确的临床及解剖学描述可能为“急性细菌性喉气管支气管炎”，但大多数教材和出版物的优选术语是“细菌性气管炎”。 (参见下文‘发病机制和病理学’)

其他已被用于描述气管软组织的侵袭性渗出性细菌感染的术语包括：“细菌性哮吼”、“膜性哮吼”、“伪膜性喉炎”、“急性喉气管支气管炎”和“膜性喉气管支气管炎”[6]。

发病机制和病理学

健康个体的喉部通常定植有上气道常见的细菌种类，其中一些是潜在的病原体(如，金黄色葡萄球菌、肺炎链球菌、革兰阴性肠道细菌和铜绿假单胞菌)，这些定植菌可扩展到(至少短暂性地)气管[7]。气管内细菌定植可能在出生后24小时内出现，即使出生时胎龄小于31周的婴儿亦如此[8]。

细菌性气管炎几乎总发生在有既往气道黏膜损伤的情况下，也发生于有前驱性病毒感染的情况下[9,10](参见下文‘病毒性易感因素’)。上呼吸道细菌感染(如，急性细菌性鼻窦炎和链球菌性咽炎)时将带菌分泌物吸入气管或扁桃体切除术后，也可能导致细菌性气管炎[9,11]。

                    

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Literature review current through: 2017-07 . | This topic last updated: 2017-07-27.
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