The Clinical Features Of Pediatric Empyema

Objective: To investigate developing process, etiology, treatment status and progress, based on the clinical investigation. To improve the pediatrician understands of pediatric empyema. To improve the overall level of diagnosis and treatment of empyema in children.Methods: Children suffered from empyema treated in the Hospital of Hebei Province between 2003 and 2013 were analyzed retrospectively. The seasonal distribution, the case numbers, City-rural distribution, age distribution, etiology, treatment status and progress were analyzed. To provide reference to the prevention, diagnosis, and treatment of Pediatric empyema in Hebei Province.Results:1 161 cases of Pediatric empyema(92 boys(57%) and 69 girls(43%)) were treated. The peak incidence age was between 3 and 6 years old(37%).2 Handan and Xingtai were the most epidemic area(111 cases(69%)). The incidence was much higher in country than in city(139:22). Winter and spring were high-occurrence seasons(98 cases).3 158 cases(98%) were originated from Complicated pneumonia which was not controlled perfectly.4 Streptococcus pneumoniae and Staphylococcus aureus were the most common bacteria in the bacterial culture and pleural fluid culture. But the culture positive rate was low(only 10%).5 The most common symptoms were fever, Cough and expectoration. The most common developmental pattern is the following. Massive pleural effusion cased by complicated pneumonia was treated by pleural puncture and drainage several times, the abscess and fiberboard accumulated in the pleural cavity. Pleural fiberboard stripping was applied to deal with the chronic empyema.6 Pleural fiberboard stripping were applied on 38 cases(24%), the cased cured not by the pleural fiberboard stripping were all treated by the A thick tube continuous closed thoracic drainage in the early stage. Third generation cephalosporin or restricted antibiotics were used on the whole course. 3 cases of bronchopleural fistula and 2 cases of pneumonectomy were in this group.7 the bronchoscopic bronchoalveolar lavage and thoracoscopic pleural cavity flushing are the advances in the treatment. The can reduce the occurrence of chronic empyema and the application of open chest operation.Conclusions:1 Handan and Xingtai were the most epidemic area of pediatric empyema. The incidence was much higher in country than in city. Winter and spring were high-occurrence seasons.The epidemic stage is 3 to 6 ages. The male incidence is much higher than female.2 Streptococcus pneumoniae and Staphylococcus aureus were the most common bacteria in the bacterial culture and pleural fluid culture. But the culture positive rate was low.3 The most common developmental pattern the uncontrolled pneumonia. Thick tube continuous closed thoracic drainage is the most important treatment in the early stage.4 Effective Antibiotic treatment, supportive treatment, thick tube continuous closed thoracic drainage, Pleural fiberboard stripping are the main therapeutic measure.5 the bronchoscopic bronchoalveolar lavage and thoracoscopic pleural cavity flushing are the advances in the treatment.