ABSTRACT
Objective To investigate the clinical characteristics,diagnosis and treatment of congenital tracheobiliary fistula (CTBF) in children.Methods A case of CTBF admitted into the Department of Pediatric Respiration,Hubei Maternal and Child Health Care Hospital in 2016 was reported,and the related literatures were reviewed.The clinical features,diagnostic methods,treatment status and clinical outcomes of the disease were analyzed.Results The patient was 3 years and 7 months old.The main clinical manifestations were recurrent cough,pneumonia and atelectasis.CTBF was diagnosed by means of iodine oil radiography and treated with biological glue plugging under bronchoscopic guidance.So far,only 30 cases of CTBF have been reported in the English literatures,but only 2 cases in the Chinese literatures.The main clinical manifestations were cough,dyspnea,sputum or bile vomiting,aspiration pneumonia,atelectasis or emphysema.Diagnostic methods for CTBF included bronchoscopy,bronchial angiography and cholangiography,hepatobiliary scan,CT scan and magnetic resonance imaging.Except for this case treated with biological glue plugging under bronchoscopic guidance,all other patients were treated with surgery.The operation methods included fistula ligation,gastrostomy,liver resection,fistula jejunum Roux-en-Y anastomosis,hepatic hilum jejunum anastomosis,gallbladder jejunum anastomosis,etc.Only 4 cases died,and the rest of the patients recovered.Conclusions CTBF should be suspected in children with persistent chronic cough.Iodine oil radiography through bronchoscopy is a simple and feasible method for diagnosis of CTBF.Besides surgery,the lavage and the biological glue plugging method through bronchoscopy is also an effective way to treat CTBF in children without severe biliary malformation.
ABSTRACT
Objective: To investigate the clinical efficacy of tiotropium in children with asthma
Methods: Eighty children with newly diagnosed moderate persistent asthma were enrolled into this study. The children were randomly assigned to the fluticasone propionate aerosol group or the fluticasone propionate aerosol plus tiotropium group for 12 weeks
Results: Lung function was significantly improved in both groups at 4, 8, and 12 weeks compared with baseline [P < 0.01]. Moreover, lung function was significantly improved in the tiotropium group compared with the control group [P < 0.05]. However, there was no significant difference in the incidence of severe asthma between the two groups [36.3% and 26.8%, respectively; P > 0.05]. Compared with the control group, the number of days and frequency of short-acting beta2-adrenoceptor agonist use was significantly reduced in the tiotropium group [P < 0.05]. Awakenings during the night were also significantly decreased [P < 0.00]. There were no severe adverse reactions in either of the study groups
Conclusion: Tiotropium could significantly improve lung function, reduce the use of short-acting beta2- adrenoceptor agonists, and improve sleep in children with asthma. Furthermore, few adverse reactions were reported