儿童肺脓肿诊治进展

Advances in the Diagnosis and Treatment of Pediatric Lung Abscess

摘要: 肺脓肿(Lung abscess, LA)是肺实质在炎症反应作用下液化坏死，周围纤维化包裹形成空洞的肺部感染性疾病。其主要继发于肺部感染，其次继发于血源播散，病原体以细菌最为多见。该病在儿童中发病率低，临床表现缺乏特异性，胸部计算机断层扫描(Computed tomography, CT)为其诊断提供了重要依据。其治疗周期长，部分患儿经药物保守治疗无效，需行外科引流甚至手术切除治疗。若未对该病进行早期诊断、及时治疗，疾病可能持续进展，导致脓毒血症、支气管胸膜瘘及慢性炎症等影响预后。本文对儿童肺脓肿诊治进展进行总结，以期为肺脓肿的早期识别、诊断及治疗提供帮助，从而改善预后。

Abstract: Lung abscess (LA) is a pulmonary infectious disease characterized by liquefaction and necrosis of the lung parenchyma induced by inflammatory reactions, followed by the formation of cavities surrounded by fibrous encapsulation. It mainly occurs secondary to pulmonary infection, followed by hematogenous dissemination, with bacteria being the most common pathogens. The incidence of lung abscess is relatively low in children, and its clinical manifestations lack specificity. Chest computed tomography (CT) provides an important basis for its diagnosis. The treatment course of this disease is prolonged. Some children fail to respond to conservative medical treatment and require surgical drainage or even surgical resection. Without early diagnosis and timely intervention, the disease may progress continuously, leading to adverse prognostic outcomes such as sepsis, bronchopleural fistula, and chronic inflammation. This article reviews the advances in the diagnosis and treatment of pediatric lung abscess, aiming to facilitate the early identification, diagnosis and management of the disease, thereby improving the prognosis of affected children.