Clinical Features Of 63 Childhood Influenza Complicated With Plasticized Bronchitis

Purpose To summarize the clinical characteristics of children with influenza complicated with plastic bronchitis,and analyze the clinical features and risk factors of severe influenza with plastic bronchitis(PB),so as to provide a reference for improving the early diagnosis and treatment of clinical pediatricians and improving the success rate of rescue.Method A retrospective analysis was carried out on the clinical symptoms,signs,laboratory examinations,imaging examinations,treatment and outcomes of 63 children with influenza complicated with PB.Risk factors for early atelectasis,admission to the intensive care unit(ICU),and the need for mechanical ventilation in children with severe influenza complicated with PB were analyzed.Result 1.Among the 63 cases,52 were male and 11 were female.2.Of the 63 cases,42 had influenza A,including 9 cases of H1N1(14%),2 cases of H3N2(3%),and 31 cases of other influenza A(49%).The remaining 21 children had influenza B(34%).3.Children of pre-school age had the highest incidence of influenza,with 38 cases(60.3%)occurring in children aged 3-6 years.4.Influenza occurred in all seasons throughout the year,with the highest incidence occurring in spring and 23 cases(36.5%)from January to March.5.Fifteen children had underlying diseases,including 6 cases of nephrotic syndrome.6.The main clinical manifestations were high fever,cough and shortness of breath,among which 24 cases(38.1%)had ultra-high fever with a heat peak exceeding 40℃.7.The presence of moist rales in the lungs is not a necessary basis for judging influenza pneumonia,and there were 16 cases(25.4%)without rales in the early stage.8.Chest X-ray examination revealed atelectasis in 24 children(38.1%).Logistics regression analysis found that elevated white blood cell count was an independent risk factor for atelectasis in children with influenza complicated with PB.9.Forty-one cases were admitted to ICU.Logistics regression analysis found that ultra-high fever(≥40℃)and three-depression sign were independent risk factors for ICU admission due to influenza complicated with PB.10.There are 32 cases of assisted ventilation with the help of a ventilator.Logistics regression analysis found that ultra-high fever(≥40℃),Influenza A virus infection,three-depression sign and elevated white blood cell count were independent risk factors for influenza complicated with PB requiring mechanical ventilation.11.Only 28 cases(44.4%)were treated with oseltamivir orally within 48 hours of the onset of the disease.All children underwent bronchoscopy and alveolar lavage,and their condition improved after treatment.12.Three children died of influenza-related encephalopathy,two children developed necrotizing pneumonia due to secondary infection,and the rest had a satisfactory prognosis.Conclusion Influenza is still a widespread public health disease in children,of which plastic bronchitis(PB)is a critical complication.Males and children aged 3-6 years are in danger of contracting influenza complicated with PB.It is important to be alert to the possibility of PB in children with influenza complicated with shortness of breath,even if their chest X-rays do not indicate atelectasis.Early bronchoscopy lavage is the only and most effective means of this disease.