Clinical Application Of Holmium:YAG Laser Via Bronchoscopy In Bronchitis Obliterans Of Children

Objective: This study aimed at analyzing the clinical characteristics and treatments of bronchitis obliterans in children,as well as assessing the efficacy and safety of oral drugs and Holmium:YAG laser combined with bronchoscopy management.Methods: The analysis was done on data of 23 patients with bronchitis obliterans diagnosed with the inclusion criteria, and treated in The first hospital of Jilin University from Oct.2013 to Dec.2015. Their clinical manifestation, etiology and auxiliary examination were summarized. According to the difference therapeutic schemes, 7 cases of the children were recruited as the drug therapy group, and the other 16 cases of children were used as the comprehensive therapy group. The clinical indexes were regularly followed-up, in order to discussion that which therapy is the most efficient and safe for bronchitis obliterans in children.Results: 1.Of the 23 cases, 13 were male and 10 were female. Their age ranged from 6 months to 13 years, among them 11 cases were infancies. The clinical symptoms of these bronchitis obliterans were repeated coughing(100%), tachypnea(100%), and exercise intolerance(91.3%); The results of physical examination showed that the most commom signs was tubular sound(69.6%); 18 cases(78.3%) were secondary to severe pneumonia; 20 cases(87%) were infected with mycoplasma pneumoniae. 2.HRCT revealed that 8 cases of anis-ventilation(34.8%), 6 cases of atelectasis(26%),6 cases of air-bronchogram(23%) and 3 cases of bronchial wall thickening (13%), among them 18 cases were combined with inflammation interspersed. The constrictive obstruction occurred in 17 cases(74%), while mixed pattern in 6 cases(26%). 3.Bronchoscopy findings included bronchial obstruction and fiberboard formation of all the cases. 4.Compared with drug therapy group, the t PTEF/t E、v PTF/v T、t I/t E were apparently higher after 6 months, the differences were statistically significant(P<0.05). And the comprehensive therapy group were also significantly higher, only after 72 hours, then VT/kg posttreatment was elevated 6 months later, the differences were statistically significant(P<0.05). The frequency of the wheezing seizure and the frequency of hospitalization of the comprehensive therapy group were remarkable lower than the drug therapy group(P<0.05). Bronchoscopy and HRCT findings showed that the comprehensive therapy group was superior to the other group.Conclusion: 1. The bronchitis obliterans in children were familiar secondary to severe pneumonia, especially infected with mycoplasma pneumoniae. The clinical symptoms were mainly with repeated coughing, tachypnea, and exercise intolerance. The child who got repeated coughing or wheezing, and abnormalities of HRCT or lung function, should undertake the bronchoscopy. 2. Bronchoscopy is the main means of the diagnosis for bronchitis obliterans in children. 3. The Ho:YAG laser via bronchoscopy combined with drug is more efficient and safe for bronchitis obliterans in children, could extended.