Efficacy of early treatment via fiber bronchoscope in children with Mycoplasma pneumoniae pneumonia complicated by airway mucus obstruction / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the efficacy of early treatment via fiber bronchoscope in children with Mycoplasma pneumoniae pneumonia (MPP) complicated by airway mucus obstruction.</p><p><b>METHODS</b>According to the time from admission to the treatment via fiber bronchoscope, the children with MPP who were found to have airway mucus obstruction under a fiber bronchoscope were randomly divided into early intervention group (≤3 days; n=40) and late intervention group (>3 days; n=56). The two groups were compared in terms of clinical data and imaging recovery.The children were followed for 1-3 months.</p><p><b>RESULTS</b>Of the 96 children, 38 were found to have the formation of plastic bronchial tree, among whom 10 were in the early intervention group and 28 were in the late intervention group (P=0.01). Compared with the late intervention group, the early intervention group had a shorter duration of fever, length of hospital stay, and time to the recovery of white blood cell count and C-reactive protein (P<0.05), as well as a higher atelectasis resolution rate (P<0.05). Compared with the late intervention group, the early intervention group had a higher percentage of children with a ≥ 60% absorbed area of pulmonary consolidation at discharge. After 3 months of follow-up, the early intervention group had a higher percentage of children with a ≥ 90% absorbed area of pulmonary consolidation than the late intervention group (80% vs 55%; P=0.01), and the early intervention group had a lower incidence rate of atelectasis than the late intervention group (P<0.05).</p><p><b>CONCLUSIONS</b>Early treatment via fiber bronchoscope can shorten the course of the disease and reduce complications and sequelae in MPP children with airway mucus obstruction.</p>

Clinical analysis of 12 cases of childhood atypical endobronchial tuberculosis / 中华实用儿科临床杂志

Objective To analyze the clinical characteristics of atypical endobronchial tuberculosis(EBTB) in children and explore the value of bronchoscopy examination in diagnosis and treatment of this disease.Methods The records of 12 children diagnosed as atypical EBTB in Children's Hospital of Chongqing Medical University from Jan.2008 to Dec.2011 were reviewed,and their medical history,clinical manifestation,imaging and laboratory findings were analyzed.They all had fiberoptic bronchoscopy and bronchoalveolar lavage.Four patients had bronchial lining pathologic biopsy.Bronchoscope findings of the 12 children were analyzed.Results The clinical manifestations of childhood atypical EBTB were various.The major were cough(11 cases,91.7％) and fever(7 cases,58.3％),other manifestations included wheeze (3 cases,25.0％),shortness of breath following exercise (2 cases,16.7％),and so on.Only 1 case had hemoptysis (8.3％).The major imaging findings were lymph node enlargement of hilar and(or) mediastinum (10 cases,83.3％).Five cases were with obstructive pulmonary emphysema and atelectasis (41.7％).It was more common than other type of pulmonary tuberculosis.It mainly expressed granulation tissue and neoplasm (7 cases,58.3％),caseoussubstance (4 cases,33.3％),extrinsic compression (4 cases,33.3％) and narrowed orifice of the lobe bronchus (2 cases,16.7％) under fiber bronchoscopy.The detection rate of mycobacterium tuberculosis was 50.0％ (6 cases) through bronchoalveolar lavage fluid.Four children were diagnosed by transbronchial biopsy and 2 children were diagnosed by gastrointestinal fluid smear after fiberoptic bronchoscopy.Conclusions The clinical manifestations of childhood atypical EBTB are various.Bronchoscopy examination,bronchoalveolar lavage and transbronchial biopsy play very important role in diagnosis and pathological classification of childhood atypical EBTB.