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儿童支气管扩张症的临床表现与评估

Authors
Khoulood Fakhoury, MD
Adaobi Kanu, MD
Section Editor
George B Mallory, MD
Deputy Editor
Alison G Hoppin, MD
Translators
陈筱青, 副主任医师

引言

支气管扩张症是一种以支气管树的异常扩张和扭曲变形为特征的结构性异常，可导致慢性阻塞性肺疾病。该病通常是多种病理生理过程导致支气管壁变薄、易塌陷、发生慢性炎症和黏液分泌物阻塞的最终结果。伴随的表现包括肺不张、肺气肿、纤维化和支气管血管肥厚。

在发达国家，囊性纤维化(cystic fibrosis, CF)是儿童支气管扩张症最常见的原因。CF相关支气管扩张症的评估将在别处讨论。 (参见“Cystic fibrosis: Clinical manifestations and diagnosis”和“Cystic fibrosis: Clinical manifestations of pulmonary disease”)

除CF之外，支气管扩张症还可由很多疾病引起，最常见的包括支气管阻塞合并感染。导致支气管扩张症的疾病类型因患者群体和年龄层而异。感染和获得性疾病所导致的支气管扩张症更常见于成人和发展中国家，而支气管或免疫系统的先天性异常更常见于儿童和工业化国家。

本专题将概述儿童非CF相关性支气管扩张症的临床表现与评估。儿童非CF相关性支气管扩张症的病因与治疗，以及成人支气管扩张症的临床表现和诊断，将单独讨论。 (参见“儿童支气管扩张的原因”和“不伴囊性纤维化的儿童支气管扩张的处理”和“成人支气管扩张症的临床表现和诊断”)

临床表现

持续咳嗽是儿童支气管扩张症最常见的症状，见于80%-90%的儿科支气管扩张症患者，而且通常是有痰的“湿性”咳嗽[1,2]。57%-74%的儿童还咯脓痰。无痰并不能排除支气管扩张症，因为年幼儿童可能无法咳出痰。

          

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Literature review current through: 2017-07 . | This topic last updated: 2016-09-12.
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References
Top
  1. Karakoc GB, Yilmaz M, Altintas DU, Kendirli SG. Bronchiectasis: still a problem. Pediatr Pulmonol 2001; 32:175.
  2. CLARK NS. Bronchiectasis in childhood. Br Med J 1963; 1:80.
  3. Sethi GR, Batra V. Bronchiectasis: causes and management. Indian J Pediatr 2000; 67:133.
  4. Kumar NA, Nguyen B, Maki D. Bronchiectasis: current clinical and imaging concepts. Semin Roentgenol 2001; 36:41.
  5. Marwah OS, Sharma OP. Bronchiectasis. How to identify, treat, and prevent. Postgrad Med 1995; 97:149.
  6. Cockrill BA, Hales CA. Allergic bronchopulmonary aspergillosis. Annu Rev Med 1999; 50:303.
  7. Bolman RM 3rd, Wolfe WG. Bronchiectasis and bronchopulmonary sequestration. Surg Clin North Am 1980; 60:867.
  8. Woodring JH, Howard RS 2nd, Rehm SR. Congenital tracheobronchomegaly (Mounier-Kuhn syndrome): a report of 10 cases and review of the literature. J Thorac Imaging 1991; 6:1.
  9. Van Schoor J, Joos G, Pauwels R. Tracheobronchomegaly--the Mounier-Kuhn syndrome: report of two cases and review of the literature. Eur Respir J 1991; 4:1303.
  10. Daniel TL, Woodring JH, Vandiviere HM, Wilson HD. Swyer-James syndrome--unilateral hyperlucent lung syndrome. A case report and review. Clin Pediatr (Phila) 1984; 23:393.
  11. Kollée LA, van Heeswijk PJ, Schretlen ED. Unilateral hyperlucent lung with decreased vascular markings (Swyer-James syndrome). Padiatr Padol 1975; 10:10.
  12. Smith IE, Flower CD. Review article: imaging in bronchiectasis. Br J Radiol 1996; 69:589.
  13. Rencken I, Patton WL, Brasch RC. Airway obstruction in pediatric patients. From croup to BOOP. Radiol Clin North Am 1998; 36:175.
  14. Piccione JC, McPhail GL, Fenchel MC, et al. Bronchiectasis in chronic pulmonary aspiration: risk factors and clinical implications. Pediatr Pulmonol 2012; 47:447.
  15. Pizzutto SJ, Grimwood K, Bauert P, et al. Bronchoscopy contributes to the clinical management of indigenous children newly diagnosed with bronchiectasis. Pediatr Pulmonol 2013; 48:67.