Clinical Analysis Of69Cases With Tracheobronchomalacia Of Children

Objective:Summarize all the data including the incidence, clinical manifestation, thecharacteristics under bronchoscopy and the prognosis of the children withtracheobronchomalacia to identify the merits of bronchoscopy, additionally, tooffer reference to the diagnosis and treatment of tracheobronchomalacia.Methods:Totally201patients younger than5years old with continuous/recurrentwheezing or chronic cough, recurrent pneumonia during January2009toOctober2013from the1sthospital of Jilin University were collected assubjects.69were diagnosed with tracheobronchomalacia through bronchoscopy.Clinical data including the general condition, clinical manifestations, the resultsof accessory examinations including bronchoscopy results, treatment andfollow-up prognosis were retrospectively analyzed.Result:1. Among the69patients of tracheobronchomalacia,52cases were babyboys and17cases are baby girls. The ratio of male to female was about3:1,Thedetectable rate of the male group was significantly higher than that of thefemale group (P＜0.05).2. Of the69patients,40patients were younger than1years old,27patients were1~3years old and only2patients were older than4years old.According to the data, the youngest tracheobronchomalacia patient was only6days old, and the oldest patient was4years old. The detectable rate of youngerthan1years old group was much higher than the other two groups. Thedifference was statistically significant (P＜0.05). 3.12patients were diagnosed as tracheomalacia,17patients werediagnosed as tracheobronchomalacia and40patients were diagnosed asbronchomalacia. The malacia incidence in the right lung is more than that in theleft lung. About90%of tracheobronchomalacia patients were mild or moderatedegree.4. Other concomitant congenital malformations were common in thepatients with TBM, in this study,33cases accompany with other congenitaldysplasia of respiratory system,4cases with cardiac malformation and2withtracheoesophageal fistula.5. In this Study,32cases were with recurrent or continuous wheezing,18patients were with chronic cough,7with repeated pneumonia,8withatelectasis,2with dyspnea,2patients had long-term gurgling with sputum, and1patient with difficulty in withdrawing from mechanical ventilation.6. All the cases were diagnosed with bronchoscopy, neither x-ray norcomputed tomography and3-D reconstruction CT scan offered any informationabout malacia.7. All the patients were prescribed with bronchoalveolar lavage accordingto the local inflammation,66cases were symptomatically improved when theywere discharged, however,2cases were dead from dyspnea, and1patientsuffered from tracheotomy.Conclusions:1. The incidence of Tracheobronchomalacia is highest in boy and patientsgroup who are younger than1year old.2. The clinical manifestation of children with tracheobronchomalacia arevariable, mainly are wheezing and cough, which are very easily misdiagnosis. 3. Bronchoscopy can make a definite diagnosis oftracheobronchomalacia.