Clinical Analysis Of 72 Cases Of Bronchilitis Obliterans In Chinldren

Objective To analyse the clinical situation of the BO in children,to enhance Clinicians’ understanding of BO.Methods A retrospective analysis of clinic data of 72 cases of BO in Children’s Hospital of Chongqing Medical University from Oct 2008 to Jan.2017.We will analyse etiology,hazads,clinical features,pulmonary imaging and lung function,therapy,prognosis and so on.resultEtiology:66 cases were PIBO,28 cases were occurred after adenovirus infection;3 after ADV and PIV3 infection;5 after ADV and MP;1 after MP infection;5 after measles virus infection;2 after RSV infection;1 after RSV and PIV3 infection;1 after VZV infection;1 after H1N1 infection;1 after CP infection;18 unknow.3 after HSCT,1 after SJS;1 after PNP;1 after gas suction;.Clinical features :All had wheezing and shortness of breath after exercise;69 cases had persistent cough;14 cases had dyspnea;64 cases had wheeze,68 cases had crackles;21 cases had extended expiratory phase,37 cases had retraction,1 case had clubbing finger.Pulmonary imaging:CT was taken in 72 cases,the inflated lung in 61 cases;mosaic perfusion were seen in 45 cases;the ground glass change in 41 cases;bronchial wall thickening in 19 cases;bronchiectasis in 15 cases;pulmonary atelectasis in 13 cases;pulmonary hyperinflation in 11 cases;stenosis of bronchial wall in 3 cases;lung consolidation in 8 cases;pulmonary fibrosis in 2 cases.Pulmonary function test:49 patients underwent pulmonary function examination showed obstructive ventilatory dysfunction.severe obstruction were seen in 15 cases,moderate obstruction in 27 cases,mild obstruction in 7 cases.Treatment:Fllowing up of 43 cases,3 cases of death;29 cases regularly used of low-dose corticosteroid or(and)azithromycin;3 cases underwent MCS treatment.The outcome of followed up was that 30 cases were improved in clinical manifestations,8 cases had no improvement;2 cases got worse.Conclusion Most BO patients occured among infants and young children,and boys were susceptible to the disease.In childern,PIBO was the main component.And adenovirus infection was the common cause of PIBO.There was no correlation between the infection pathogens and the time of the first lower respiratory infection,the time of diagnosis,the sex and the length of hospital stay.The main direct signs of pulmonary imaging were bronchiectasis and thickening of bronchial wall.The indirect signs were inflated and mosaic perfusion sign,which could be developed as pulmonary fibrosis.Pulmonary function suggests that different degree of ventilation function obstruction.There is no definitive treatment for children with BO,and the treatment of corticosteroid and azithromycin may have curative effect,and the treatment of mesenchymal stem cells may be significant to BO patients.