兒童細菌性社區感染型肺炎併發症

Complications of community-acquired Bacterial Pneumonia in Children

林世雄(Shih-Hsiung Lin) ； 戴任恭(Zen-Kong Dai)

《中華民國兒童胸腔醫學會雜誌》 6卷1期 (2009/10) Pp. 16-23

https://doi.org/10.6322/JPRD.200910_6(1).0003

摘要

當病童因為兒童社區感染型肺炎(community-acquired pneumonia)住院治療48小時後病情沒有改善時，肺炎併發症就必須考慮。兒童肺炎併發症有肺膿瘍(lung abscess)、肋膜積水及膿胸(pleural effusion and empyema)以及壞死性肺炎(necrotizing pneumonia)。肺膿瘍必須考慮病人有沒有潛在性疾病來決定可能之致病菌並給予適當抗生素治療。在診斷肺炎併發症時，除胸部X光外，胸部超音波更是兒童胸腔科醫師的利器。因此，兒童胸腔科醫師必須要有正確判讀胸部X光能力外，也必須要有操作胸部超音波的能力。在治療上，正確且沒有後遺症的引流管置放在處理肺炎併發症病人也是不可或缺的能力。

關鍵字

肺炎 ； 併發症 ； 肺膿瘍 ； 肋膜積水 ； 膿胸 ； 壞死性肺炎

並列摘要

Within 48 hours of treatment children with community-acquired pneumonia (CAP) should exhibit sign of improvement. If not, physicians should be concerned of complications. Complications of CAP include lung abscess, pleural effusion and empyema, and necrotizing pneumonia. To treat lung abscess, appropriate antibiotics must be given to treat the possible organism which should be decided based on the patient's underlying disease. In addition to chest x-ray, lung ultrasonography (LUS) is of great benefit to survey complications of CAP for pediatric pulmonologists. Therefore, it is very important for pediatric pulmonologists to read chest x-ray correctly and perform LUS skillfully. Furthermore, it is also imperative for pediatric chest specialists to correctly place the chest drainage tube without complications.

並列關鍵字

pneumonia ； complications ； lung abscess ； pleural effusion ； empyema ； necrotizing pneumonia