本文選題：支氣管肺發(fā)育不良 + 再入院　； 參考：《中國當(dāng)代兒科雜志》2017年10期

【摘要】：目的總結(jié)支氣管肺發(fā)育不良(BPD)患兒2歲內(nèi)再入院的臨床情況。方法回顧性分析121例BPD患兒2歲內(nèi)242例次因反復(fù)下呼吸道感染再入院的臨床資料。結(jié)果 242例次再入院BPD患兒中,115例次(47.5%)有喘息;1~2歲患兒喘息發(fā)生率高于1歲內(nèi)患兒(P0.05)。193例次行胸部影像學(xué)檢查,結(jié)果示囊泡影31例次(16.1%)。肺功能檢查結(jié)果示BPD患兒的每公斤體重潮氣量(TV/kg)、達(dá)峰時間比(TPEF/TE)、達(dá)峰容積比(VPEF/VE)、50%潮氣量時的呼氣流速(TEF50)、75%潮氣量時的呼氣流速(TEF75)均低于無呼吸道疾病的對照組,而呼吸頻率高于對照組(P0.05)。28例行支氣管鏡檢查,氣道發(fā)育異常21例(75%)。242例次均吸入糖皮質(zhì)激素,無治療相關(guān)不良反應(yīng)發(fā)生;6例次靜脈使用人臍血間充質(zhì)干細(xì)胞(hUCB-MSCs),無不良反應(yīng)發(fā)生,其中1例治療后順利脫氧。結(jié)論因下呼吸道感染再入院BPD患兒喘息發(fā)生率隨年齡增長而增高,其肺功能以小氣道阻塞、低肺容量時呼氣流速降低和呼吸頻率增快為主要表現(xiàn),多伴有氣道發(fā)育異常。吸入糖皮質(zhì)激素可用于BPD再入院患兒急性期抑制炎癥反應(yīng);hUCB-MSCs輸注后短期安全可行,并提示可能對BPD恢復(fù)有一定益處。
[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.
【作者單位】： 重慶醫(yī)科大學(xué)附屬兒童醫(yī)院呼吸科/兒童發(fā)育疾病研究教育部重點(diǎn)實(shí)驗(yàn)室/兒童發(fā)育重大疾病國家國際科技合作基地/重慶市干細(xì)胞治療工程技術(shù)研究中心;
【基金】：重慶市科委應(yīng)用開發(fā)重大項(xiàng)目基金(cstc2014yykf C10003)
【分類號】：R725.6

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本文編號：1827834