Clinical Analysis Of Characteristics Of Plastic Bronchitis In Children

Object:To analyze the clinical features of plastic bronchitis(PB)in children with or without assisted ventilation,and to improve the understanding of the diagnosis and treatment of PB.Methods:The clinical data of 48 children were analyzed retrospectively.They were divided into mechanical ventilation group(n=21)and non-mechanical ventilation group(n=27)according to whether they had assist ventilation or not.Related clinical data were collected,including general information,clinical manifestations,laboratory examination,imaging findings,treatment,and prognosis.Result:The main symptoms of the two groups were fever and cough.Compared with the non-mechanical ventilation group,patients who got mechanical ventilation were much younger,the proportion of males was higher,and the hospitalization time was longer(P<0.05).The incidences of fever,allergic diseases and polypnea in children with mechanical ventilation were significantly higher than those without auxiliary ventilation(P < 0.05),and the proportion of neutrophils was higher(P <0.05).Most of the children of the two groups were infected with mycoplasma pneumonia.The proportion of adenovirus(P > 0.05)and influenza virus infection was higher in the mechanical group(P < 0.05),the main chest imaging manifestations were pulmonary consolidation,atelectasis and pleural effusion in the two groups.Bronchoscopy lavage were performed in both groups,and the median times of bronchoscopy lavage were more in the mechanical ventilation group(P < 0.05).In the mechanical ventilation group,4 cases were treated with ECMO,including3 males,1 of them died,2 complicated with lower lobe atelectasis and bronchiolitis obliterans,and 1 female complicated with bronchiectasis.In the assisted ventilation group,in addition to the dead children above,2children died and 4 children had atelectasis when they were discharged from the hospital,and there was no special after regular treatment.In the non-assisted ventilation group,8 cases still had atelectasis at discharge,but there was no special after regular treatment,and 1 case relapsed one year after discharge.Conclusion:The clinical manifestations of PB are various and atypical.If a preschool male child with allergic history has persistent high fever,polypnea,the proportion of neutrophils and numerical value of LDH increasing obviously,and the chest imaging indicates pulmonary consolidation or atelectasis,besides considering the occurrence of PB,we should notice the occurrence of severe PB.We could give the patients bronchoscopy early,if necessary,with multiple lavage and supportive treatment to improve the prognosis.Among the children with PB caused by infection factors,influenza virus infection is more likely to develop severe PB,followed by adenovirus and Mycoplasma pneumoniae.