The Clinical Research Of Infectious Atelectasis In Children

ObjectiveTo Analysis Clinical characteristics、affected part and pathogen of infectiousatelectasis in children. To explore the effect of bronchoalveolar lavage on infectiousatelectasis in children. To provide theoretical basis for diagnosis and treatment of thechildren’s infectious atelectasis.MethodsRetrospectively analysis was adopted.125children who were diagnosed withinfectious atelectasis were selected, who were hospitalized in the respiratory ward ofDalian Children’s Hospital during the period from January2010to January2013. Theirages ranged from2months to15years old.125patients were admitted to bloodsamping at the8th day of course. Blood serum was acquired after centrifugation.Passive agglutination method was applied to mycoplasma pneumoniae serum IgMantibody detection. By application indirect enzyme-linked immunoassay, influenza、parainfluenza、adenovirus and respiratory syncytial virus、Epstein-Barr virus andcoxsackie virus serum IgM antibody was determined. Bronchoscopy was done in64patients and bronchoalveolar lavage fluid was collected. Bronchoalveolar lavage fluidspecimens were respectively inoculated blood culture medium, chocolate AGAR media,eosin methylene blue and35℃CO2incubator incubation. Bacteria identificationinstrument was used to identify the species if there is bacteria growth after24h~48hobservations. Bronchoalveolar lavage treatment was done in64patients. Record thefrequency of lavage treatment、the time of lavage treatment、recovery time of infectiousatelectasis and microscopic performance of bronchoscopy. The results above cases wererecorded to registration form.Results1. The most patients in125cases of infectious atelectasis are in preschool-age and school-age, including3~6years old accounting for40%、6~15years old accountingfor36.8%.The incidence of cough is the highest accounting for100%in various kindsof clinical symptoms of infectious atelectasis, followed by fever accounting for91.2%.Atelectasis of Single lung lobe is majority in infectious atelectasis, up to97.6%. Themiddle lobe of the right lung is majority accounting for35.1%and the left lower lobe isthe least accounting for9.4%in the location of infectious atelectasis.2.Infection rate of the single pathogen is the highest in the64patients of infectiousatelectasis accounting for50.0%, followed by the mixed pathogen infection accountingfor31.2%. The pathogen is not clear, accounting for18.8%. Mycoplasma pneumoniaeinfection rate is the highest in74cases of infection in64patients with infectiousatelectasis accounting for45.9%, followed by bacterial infection rate accounting for36.5%, and virus infection rate is the lowest accounting for17.6%. H.influenzae ismajority accounting for33.3%, followed by S.pneumoniae accounting for22.2%,Klebsiella pneumoniae、S.pyogenes、rod coli and enterococcus are the least eachaccounting for3.7%in the results of27cases with cultured positive bacteria.Adenovirus infection rate is the highest accounting for31.8%, followed by respiratorysyncytial virus infection rate accounting for27.3%and the influenza virus infection rateis the lowest accounting for4.5%in22patients with virus infection.3.The incidence of bronchial mucosa hyperemia、 oedema and Secretionscongestion are up to100%, followed by the incidence of bronchial inflammatorystenosis accounting for70.3%and the incidence of granulation tissue congestion is thelowest accounting for1.6%in the microscopic performance of bronchoscopy. T test wasadopted on the difference of the first the first bronchoalveolar lavage treatment timebetween the patients whose recovery time is less than a month and the patients whoserecovery time is more than a month. As a result, t=3.822, P＜0.01, they are significantlydifferent and statistically significant. The Spearman rank correlation analysis is adoptedbetween the first bronchoalveolar lavage treatment time and the recovery time ofinfectious atelectasis. As a result, rs=0.585, P＜0.01, they have a positive correlation.Conclusions1.The age of the highest incidence of children’s infectious atelectasis is inpreschool-age and school-age. The main clinical manifestations are cough and fever.Atelectasis of Single lung lobe is more than95%in infectious atelectasis. The middlelobe of the right lung is mostly in the location of infectious atelectasis. 2.About half of the patients is a single pathogen infection in the infectiousatelectasis of children. Mycoplasma pneumoniae infection is the highest accounting for45.9%, followed by bacterial infection accounting for36.5%, virus infection accountingfor a third of17.6%in various pathogens of infectious atelectasis. H. influenzae is thehighest accounting for33.3%, followed by S.pneumoniae accounting for22.2%in thebacterial infection. Adenovirus infection is the highest accounting for31.8%, followedby respiratory syncytial virus infection accounting for27.3%in the virus infection.3.The incidence of bronchial mucosa hyperemia、oedema and secretions congestionis the highest up to100%, followed by the bronchial inflammatory stenosis accountingfor70.3%in the microscopic performance of bronchoscopy. The first bronchoalveolarlavage treatment time of patients whose recovery time is less than1month issignificantly shorter than patients whose recovery time is longer than1month in acuteinfectious atelectasis. There is a positive correlation between the first bronchoalveolarlavage treatment time and the recovery time of infectious atelectasis. Earlybronchoalveolar lavage treatment can shorten the recovery time.