NGHIÊN CỨU ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ KẾT QUẢ ĐIỀU TRỊ VIÊM MỦ MÀNG NGOÀI TIM Ở TRẺ EM TẠI BỆNH VIỆN NHI TRUNG ƯƠNG

Abstract

Objectives: To determine clinical, subclinical, treatment and treatment outcomes for purulent pericarditis in children at the National Children’s Hospital. Patients and methods: Research on 42 patients with purulent pericarditis at Central Children’s Hospital, between09/2015 - 08/2020. Results: average age is 5.4 ± 4.5; The ratio of male/female is 1.6/1. Common symptoms are fever 97.6%; breathlessness 76.2%; diminished heart sound 66.7%; 71.4% tachycardia; 59.5% hepatomegaly; chest pain 52.4%. Inflammatory reactions appear in most patients with increasing leukocytosis (81%); increasing CRP (100%). The positive blood culture was 19% and the positive pericardial fluid culture was 35.7% of which 86.7% was S. aureus and 13.3% was S. pyogen. 100% echocardiography had moderate or severe pericardial effusion, of which 61.9% was severe effusion, 61.9% had collapsed right atrium, 81.0% fluid had fibrin. The treatment includes 100% antibiotics, of which the most commonly used are vancomycin (83.3%) and 3rd generation cefalosporin (81%); pericardial drainage and drains the pericardial fluid(35.7%). Surgical treatment includes pericardiectomy (52.4%); drains the pericardial fluid surgery (7.1%) and opens the pericardial window (4.8%). No patient died as a result of treatment, only 2 cases (4.8%) had Pick syndrome. Conclusion: Pericarditis is uncommon disease however it can results in high mortality unless it is early diagnosis and management. Patients usually have various non-specific symptoms and misdiagnosed with other cardiac diseases. Most cases are caused by bacteria, especially S.aureus. Echocardiography still plays an important role in early diagnosis of pericarditis so far. Antibiotic therapy and surgery intervention help improve the outcome.