Clinical Analysis And Etiology Discussion Of Pulmonary Bullae In Children

Objective:Explore the clinical features,etiology and mechanism of pulmonary bullae in children.Methods:The clinical data of children with diagnosis or suspected diagnosis of pulmonary bullae in the inpatient department of Children’s Hospital of Chongqing Medical University from March 1993 to August2019 were retrospectively analyzed,including the cause of disease,etiology,lacation,et al.Results : Among the 163 patients,130 cases of respiratory tract infection.11 cases of pneumothorax alone.22 cases were found pulmonary bullae in the chest CT examination without typical sympotom.Etiology:Viruses account for 19.02%,mainly respiratory syncytial virus(15 cases).Bacterial infection accounts for 28.83%,mostly Haemophilus influenzae(13 cases,7.98%)and Staphylococcus aureus(10 cases,6.13%).Bullae was more common in the right lung(82/163).It took 7 days to 9 months for the bullae to reduct,shrink or disappear;In some cases,there is no significant change in bullae even after 19 months.Conclusion : Pulmonary bullae can be seen in infection,tumor,autoimmune diseases and so on,most of which are bacterial infections;Bullae may exist for a long time.The mechanism of pulmonary bullae mayinclude narrowing of the lumen followed by thickening of the bronchial wall,ischemic necrosis and alveolar expansion due to the clogging of distal small vessels or capillaries,degradation of connective tissue and dissociation of elastic tissue,destruction of the bronchiolar wall,disturbing ion channels and mitochondria Metabolism and destrying the connection of epithelial cells.