121例支气管肺发育不良患儿2岁内再入院的临床分析

发布时间：2018-05-01 05:03

本文选题：支气管肺发育不良 + 再入院　；参考：《中国当代儿科杂志》2017年10期

【摘要】：目的总结支气管肺发育不良(BPD)患儿2岁内再入院的临床情况。方法回顾性分析121例BPD患儿2岁内242例次因反复下呼吸道感染再入院的临床资料。结果 242例次再入院BPD患儿中,115例次(47.5%)有喘息;1~2岁患儿喘息发生率高于1岁内患儿(P0.05)。193例次行胸部影像学检查,结果示囊泡影31例次(16.1%)。肺功能检查结果示BPD患儿的每公斤体重潮气量(TV/kg)、达峰时间比(TPEF/TE)、达峰容积比(VPEF/VE)、50%潮气量时的呼气流速(TEF50)、75%潮气量时的呼气流速(TEF75)均低于无呼吸道疾病的对照组,而呼吸频率高于对照组(P0.05)。28例行支气管镜检查,气道发育异常21例(75%)。242例次均吸入糖皮质激素,无治疗相关不良反应发生;6例次静脉使用人脐血间充质干细胞(hUCB-MSCs),无不良反应发生,其中1例治疗后顺利脱氧。结论因下呼吸道感染再入院BPD患儿喘息发生率随年龄增长而增高,其肺功能以小气道阻塞、低肺容量时呼气流速降低和呼吸频率增快为主要表现,多伴有气道发育异常。吸入糖皮质激素可用于BPD再入院患儿急性期抑制炎症反应;hUCB-MSCs输注后短期安全可行,并提示可能对BPD恢复有一定益处。
[Abstract]:Objective to summarize the clinical situation of children with bronchopulmonary dysplasia (BPD) admitted to hospital within 2 years old. Methods A retrospective analysis was made on the clinical data of 242 patients with recurrent lower respiratory tract infection (LRTI) admitted to hospital within 2 years of age in 121 patients with BPD. Results the incidence of wheezing in children aged 2 years old was higher than that in children within 1 year old (P 0.05. 193 times). The results showed that 31 cases of vesicles were diagnosed with 16.1 times. The results of pulmonary function test showed that the tidal volume per kilogram of body weight of children with BPD was higher than that of the control group with TPEF / kg, the peak time ratio and the peak volume ratio of 50% tidal volume to 50% tidal volume) were lower than those of the control group without respiratory diseases. However, the respiratory frequency was higher than that in the control group (P 0.05) .28 cases were examined by bronchoscopy, 21 cases with abnormal airway development were inhaled glucocorticoid in 75 cases and 242 cases were inhaled glucocorticoid. There were no adverse reactions in 6 cases of intravenous use of human umbilical cord blood mesenchymal stem cells (HUCB-MSCsS), and no adverse reactions. One case was deoxidized successfully after treatment. Conclusion the incidence of wheezing in children with BPD due to lower respiratory tract infection increases with age. The main manifestations of lung function are small airway obstruction, decreased expiratory flow rate and increased respiratory rate at low lung volume, and most of them are accompanied by abnormal airway development. Inhaled glucocorticoid can be used to inhibit inflammatory response in children with BPD in the acute phase. It is safe and feasible to infuse hUCB-MSCs in the short term, and suggests that it may be beneficial to the recovery of BPD.
【作者单位】：重庆医科大学附属儿童医院呼吸科/儿童发育疾病研究教育部重点实验室/儿童发育重大疾病国家国际科技合作基地/重庆市干细胞治疗工程技术研究中心;
【基金】：重庆市科委应用开发重大项目基金(cstc2014yykf C10003)
【分类号】：R725.6

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