Clinicalanalysis Of 176 Children With Congenital Tracheobronchial Malformation

Objective: To investigate the clinical characteristics of congenital tracheobronchial malformation in children.Methods: Retrospective analysis was made on the data of 176 children admitted to Children’s Hospital of Chongqing Medical University from January 2016 to October 2016 who were diagnosed as congenital tracheobronchial malformation by bronchoscopy,and were followed up by telephone for wheezing,operation and death within 3 years after discharge.Results:(1)Among the 176 cases,156 cases were less than 3 years old,accounting for 88.64%.(2)Among the 176 cases,there were 54 cases of congenital tracheobronchial stenosis,42 cases of congenital tracheobronchomalacia,26 cases of abnormal bronchial openings,3 cases of airway diverticulum,1 case of tracheoesophageal fistula,1 case of bridging bronchus,and 49 cases of mixed type(2 or more deformity).(3)The most common clinical features were recurrent or persistent wheezing(86 cases),chronic cough(61 cases),and recurrent respiratory infection(34cases).Other manifestations included laryngeal stridor(14 cases),atelectasis(29 cases),localized emphysema(6 cases),and difficulty extubation after endotracheal intubation(6 cases).(4)Among the 139 patients who underwent chest CT examination and airway reconstruction,only 44 cases were diagnosed correctly.(5)All 176 patients received routine medical treatment and bronchoscopy during hospitalization,among which 17 received surgical treatment.170 cases were improved and discharged,and 6 cases did not respond well.A total of 47 patients were followed up by telephone for 3 years.The proportion of children still wheezing after 1 year,2 years and 3 years were 59.57%,51.06% and38.30%,respectively.Among the follow-up patients,4 cases received surgical treatment and 2 cases died.Conclusion: Children’s congenital tracheobronchial malformation is often seen in infants,and their clinical manifestations are not typical.Therefore,suspected patients should have chest CT and airway reconstruction as early as possible,and bronchoscopy can be timely improved if the diagnosis is unclear.The prognosis of majority of children is good,and few children die.Partial patients have a risk of recurrent or persistent wheezing,and some critically sick children need airway stent implantation or surgical intervention.