Clinical analysis of plastic bronchitis in 7 children / 中华实用儿科临床杂志

ABSTRACT

Objective To analyze 7 cases of plastic bronchitis in children,review the literature,and improve the understanding of the clinical features,diagnosis and treatment of the disease.Methods Seven children (6 male and 1 female) aged from 2 to 12 years with plastic bronchitis presenting cough,wheezing and dyspnea,who were treated in Nanjing Children's Hospital Afiliated to Nanjing Medical University from Sep.2006 to Mar.2012,were analyzed,respectively.The treatment of the 7 cases included flexible bronchoscopy or rigid bronchoscopy,supplemented by oxygen therapy,antibiotics,and atomizing inhalation.Results All 7 children had acute onset,in which 6 cases presented cough and polypnea,1 case presented emptysis.With the development of the disease,hypoxemia occurred.The chest Xray and Computerized Tomography examination showed pulmonary atelectasis in all 7 cases,while atelectasis and emphysema coexisted in 3 cases,pleural effusion in 3 cases.According to the obstructive site,1 case was in left bronchus and 6 cases in right.One case received rigid bronchoscopy,and 1 case received flexible bronchoscopy after taking rigid bronchoscopy,while 5 cases received flexible bronchoscopy.Five cases were cured after first operation,2 cases had second flexible bronchoscopy,and endogenous bronchial-shaped casts were removed under bronchoscopy.Pathological results showed the casts were classified as 6 cases of type Ⅰ,inflammatory,and 1 case of type Ⅱ,acellular.Four cases improved markedly,and 3 cases were cured.Conclusions Plastic bronchitis in children is a life-threatening disorder.Flexible bronchoscopy or rigid bronchoscopy extraction of branching plastic casts must be performed urgently for early diagnosis and good therapeutic result.