Clinical Features’ Analysls And Application Value Of Fiberbronchoscopy Of 456 Cases Of Atelectasis In Children

Objective:To analysis the etiology and pathogen of atelectasis in children, explore the application value of fiberoptic bronchoscopy (FB) of atelectasis, so as to provide the evidence for clinical diagnosis and treatments of atelectasis.Methods:Review the data of 456 cases with atelectasis who were diagnosed in Children’s Hospital of Chongqing Medical University between June 2013 and December 2014.The etiology and pathogen of the children were analyzed. The treatment effects of atelectasis were followed up.Results:1.The age distribution of 456 cases:<1y 102 cases (22.4%),1-3y 99 cases (21.7%),3-6y 118 case (25.9%),>6y 137 cases (30.0%).2. In 456 cases of atelectasis,393 cases detected pathogens, detection rate is 86.2%.245cases (62.3%) were detected bacteria,127 cases (32.3%) were detected MP,104 cases (26.5%) were detected virus,13 cases (3.3%) were detected MTB.3. The etiology in children’s atelectasis were inflammation, foreign body, TB, the outside pipe pressure and tracheal or bronchial dysplasia. 363cases (79.6%) were inflammation.33 cases (7.2%) were foreign body. 24 cases (5.3%) were TB.21 cases (4.6%) were the outside pipe pressure. 15 cases (3.3%) were tracheal or bronchial dysplasia.4. Follow-up the treatment effects of 424 cases of atelectasis for 3 months, the rate of lung recruitment is 94.4%. The disease course ≤1month, the rate of lung recruitment is 97.4%. The disease course between 1 month and 3 month, the rate of lung recruitment is 94.7%. The disease course>3 month, the rate of lung recruitment is 78.2%. The disease course≤1 month,15.4% need be treated more than 2 times. The disease course between 1 month and 3 month,44.0% need be treated more than 2 times. The disease course>3 month,67.4% need be treated more than 2 times.Conclusions:1. Atelectasis is peaking at the children younger than 3 years.2. Bacteria is the most common pathogen in children’s atelectasis in Chongqing recently, followed by MP, virus and MTB.3. Inflammation is the most common etiology in children’s atelectasis, followed by foreign body, TB. Along with the rising incidence of TB, the percentage of atelectasis caused by TB is increasing. We should pay attention to it.4. BAL has a significant treatment effect in atelectasis. The children who’s disease course≤3 month have better treatment result than others, and they need less treatment times. The longer the disease course is, the more treatment times needed. Early BAL treatment can improve the rate of lung recruitment.