| ObjectiveTo explore the clinical characteristics of children with congenital tracheobronchomalacia,to improve its understanding and reduce misdiagnosis.MethodsQne hundred and thirty-seven children diagnosed of congenital tracheobronchomalacia with electronic bronchoscope at the first time combined with bronchopneumonia in respiratory department of Children's Hospital of Soochow University from January 1,2012 to December 31,2016,as “airway malacia group”,were retrospectively analyzed.In addition,thirty-six children due to bronchopneumonia in respiratory department of Children's Hospital of Soochow University at the same period and without malacia of the airway with electronic bronchoscope,as “non-airway malacia group”,were retrospectively analyzed.Results1.The general information:(1)There were 137 cases of airway malacia group.There were 104 males and there were 33 females.Male to female ratio was about 3:1.The age of children ranged from 1 to 31 months.There were 111 cases less than or equal to 1 year which accounted for 81.02%(male: 86,female: 25).There were 24 cases more than 12 months and less than or equal to 24 months,which accounted for 17.52%(male: 16,female: 8).There were 2 cases more than 24 months,which accounted for 1.46%(male: 2,female: 0).(2)There were 36 cases of non-airway malacia group.There were 25 males and there were 11 females.There was no statistical difference in gender ratio between the two groups(P=0.428>0.05).(3)The age of the airway malacia group was 7.00(4.35~11.40)months,and the age of the non-airway malacia group was 9.45(6.33~12.08)months.There was no statistical difference between the two groups(P=0.079>0.05).(4)The number of days before admission was 15(7~30)days in the airway malacia group,and the number of days before admission was 17.50(6.25~30.00)days in the non-airway malacia group.There was no statistical difference between the two groups(P=0.586>0.05).(5)The number of hospital days in the airway malacia group was 10(7~15)days,and the number of days in the non-airway malacia group was 11.50(9.00~14.75)days.There was no statistical difference between the two groups(P=0.212>0.05).2.Malacia site and degree:(1)In 137 cases,there were 85 cases of BM,there were 27 cases of TBM and there were 25 cases of TM.BM accounted for 62.04% of the 137 cases.(2)Malacia involving bronchial cases,there were 52 cases of the right BM.There were 41 cases of the left BM.There were 19 cases of left and right BM.(3)In 137 cases,there were 87 cases of spontaneous malacia.There were 50 cases of multiple malacia.In the cases of spontaneous malacia,there were 25 cases involving trachea,accounting for 28.74%.(4)In the cases of multiple malacia,there were 29 cases involving both parts,accounting for 58%.(5)In 137 cases,moderate malacia was seen in 101 cases.Mild malacia was seen in 27 cases.Severe malacia was seen in 9 cases.Moderate malacia accounted for 73.72%.(6)There was no statistical difference in malacia degree between children of different age groups(P=0.501>0.05,P=0.116>0.05,P=0.221>0.05).(7)In 137 cases,25 cases were combined with laryngomalacia.There was no statistical difference in malacia degree between the other airway abnormalities(P=0.331>0.05).3.Clinical manifestations:(1)The proportion of dyspnea in children with multiple malacia was higher than that in children with single malacia.There was statistical difference between the two groups(P=0.033<0.05).(2)There was no statistical difference in the clinical manifestations between different degrees of malacia(P=0.960>0.05).(3)The proportion of anhelation was higher in the airway malacia group than that in the non-airway malacia group(29.93%vs8.33%)and there was significant statistical difference between the two groups(P=0.008<0.01).The proportion of dyspnea was higher in the airway malacia group than that in the non-airway malacia group(25.55%vs2.78%)and there was significant statistical difference between the two groups(P=0.003<0.01).The proportion of inhalation trident was higher in the airway malacia group than that in the non-airway malacia group(24.82%vs5.56%)and there was statistical difference between the two groups(P=0.011<0.05).The proportion of severe pneumonia was higher in the airway malacia group than that in the non-airway malacia group(29.20%vs11.11%)and there was statistical difference between the two groups(P=0.027<0.05).4.Lung general radiography and general computed tomography examination:The results did not prompt the trachea or bronchial malacia,mainly for the performance of lung inflammation:lung imaging showed 98 cases of dotted shadow,11 cases of emphysema,6 cases of atelectasis,1 case of pulmonary consolidation,2 cases of tracheal or bronchial stenosis,1 case of bronchial degeneration,1 case of bronchial insufficiency,1 case of bronchial obstruction and 1 case of mediastinal hernia.5.Complications5.1.Bronchopneumonia:There was no statistical difference in severity of pneumonia between different degrees of malacia(P=0.571>0.05).There was no statistical difference in the severity of pneumonia between different malacia range groups(P=0.184>0.05).5.2.Other system development anomalies except airway malacia:There were 13 cases of heart disease.There were 3 cases of cerebral palsy.There were 2 cases of epilepsy.There were 2 cases of growth retardation.There was 1 case of brain injury syndrome.There were 2 cases of 21 st chromosome trisomy.6.137 children received routine treatment.It was necessary to wash and remove the secretions under the electronic bronchoscope according to the condition.The hospital stay was 10(7 ~ 15)days.Conclusions1.Congenital tracheobronchomalacia was more seen in male children within one year of age.2.BM was more common than TM,TBM.The right BM was more common than left BM.The most common malacia degree was moderate.Combined laryngomalacia was most common.3.The clinical manifestations of congenital tracheobronchialytosis in children with pulmonary infection were more severe than those with non-airway malacia.4.Pulmonary common imaging examination of the diagnosis of TM/TBM/BM was of little help. |
PDF Full Text Request