关键词: 塑型性支气管炎, 儿童, 电子支气管镜, 诊断

Abstract:

Objective    To investigate the clinical features of plastic bronchitis （PB）， to improve the understanding of PB in children. Methods    The clinical manifestations，laboratory，imaging，bronchoscopy，aspirate pathology， treatment and prognosis of PB in 53 neonates treated in Tianjin Children’s Hospital from October 2012 to January 2014 were analyzed retrospectively.   Results    Fifty-three children were finally diagnosed with PB by the pahtology examination of bronchoscopy or plastic like material of the bronchus. All the included 53 cases had the symptom of fever and cough with the higest temperature of >39℃. Of the included 53 cases, more than 80% of them had the fever period less than 1 week with the shortest fever period of less than half a day. All the cases was firstly diagnozed with the X-ray or CT presention of lung consolidation. And about 63% of children had the presention of pleural effusion. The best efficacy treatment procedure for PB was directively removing the plastic like materials combined with position drainage, physiotherapy and glucocorticoid. The mean hosptial stay was 12.6 days with cure or improvement. After 3 months’ follow-up，no recurrence case was found. Conclusion    Plastic bronchitis is severe acute disease in Department of Pediatrics. The clincial characteristics of PB are rapid development with high fever, cough, dyspnea, lung consolidation and pleural effusion. Clinial laboratory exmination usually demonstrats significant elevated serum CRP, PCT and ESR， which indicats non usefull for regular antibiotic treatment. When PB is diagnosed， the best treatment procedure is bronchoalveolar lavage therapy.

Key words: plastic bronchitis, child, electronic bronchoscope, diagnosis