Retrospective Clinical Analysis Of 41 Children With Plastic Bronchitis

Objective: To retrospectively analyze the cases of children with plastic bronchitis(PB)in Children's Hospital of Chongqing Medical University,and analyze the clinical features and prognosis of PB.Methods: Clinical data of the children diagnosed with PB in Children's Hospital of Chongqing Medical University from July 2012 to February 2019 were collected,and the prognostic data of the children were collected through telephone and outpatient follow-up,so as to analyze the clinical features and prognosis of PB.Results: 41 children were finally diagnosed with PB.Among the cases,29(70.73%)were male and 12(29.27%)were female,with a male-to-female ratio of 2.42:1.All the children were from southwest China,and the median age was three years and eight months.Fever occurred in 36 cases(91.89%),wheeze in 31(83.78%),and progressive dyspnea in 17(45.95%).Besides,there were 11 cases(26.83%)with leukocytosis,24(58.54%)with elevated C-reactive protein,18(43.90%)with elevated procalcitonin,and 9(21.95%)with elevated Alanine aminotransferase.After admission,pulmonary imaging examination was completed in all the children,including 25(60.98%)with atelectasis,15(36.59%)with pleural effusion,and 7(17.07%)with pneumothorax.While in hospital,40 children(97.56%)received bronchial endoscopy to remove the bronchial cast,and the respiratory symptoms of these children were relieved after that;18(43.90%)received mechanical ventilation.Among 41 cases,39 were discharged after improvement and 2 died.35 of the children discharge were followed up,and 27(77.14%)were basically recovered within three months,the time of bronchial endoscopy to remove the bronchial cast was positively correlated with the recovery time(r=0.545,P<0.05).PB reappeared in 3 cases,2 of which were children with abnormal pulmonary vascular reflux.Conclusion: PB is still mainly considered to be caused by infection in southwest China,especially by influenza virus,mycoplasma pneumoniae,and adenovirus infection.Early bronchial endoscopy to remove the bronchial cast can relieve respiratory symptoms and shorten the recovery time of lung inflammation.PB will occur repeatedly in children with abnormal pulmonary vascular and lymphatic reflux.