Clinical Features Of Rehospitalization And Chest CT Follow-up Of Bronchopulmonary Dysplasia In First Two Years:A 30-cases Analysis

Objective: To discuss the Clinical features of rehospitalization caused by lower respiratory tract and chest CT follow-up in the first two years of Bronchopulmonary dysplasia patients,for a better clinical practice.Methods: Retrospectively review the neonatal data,rehospitalization data and CT scan without airway infection in the first two years of 30 Bronchopulmonary dysplasia patients that came to our hospital in 2012.01-2016.12.Results:(1)there are 89 cases of rehospitalization in the first years of 30 BPD patients due to lower respiratory tract infection,media time 2.5(3),even 11 times of rehospitalization.(2)The main manifestations of rehospitalization are cough,short of breath,wheezing,cyanosis,and rales in the lung.63.2%(43/68)rehospitalization in the first year had wheezing,while 90.5%(19/21)had wheezing in the secongd year(P =0.028),but there is no significant difference in intravenous methylprednisolone use.(3)sputum culture:the most common bacterias are klebsiella pneumoniae 34.8%(25/72),streptococcus pneumoniae9.7%(7/72),Escherichia coli 8.3%(6/72).and the resistance rate to antibiotics of klebsiella pneumoniae shows they are high sensitive to meropenem,imipenem and macrodantin;RSV 62.2%(23/37),PIV3 24.3%(9/37)are the main virus pathogens.(4)there is no significant relationship between the recurrent rehospitalization(more than twice in the first year)and the neonatal events such as NRDS,apnea,asphyxia,PDA,pulmonary hypertension,sepsis,thrombocytopenia,coagulation disorders,total oxygen using time.(5)high density opacity,clouding opacity,linear opacity,reticular opacity,bubbles,ground grass,air bronchgram are the main CT features in the first two years of inpatients,there is a significant difference between outpatients and inpatients in high density opacity(P=0.011)and air bronchgram(P=0.027),bubbles decrease with time,and clouding opacity,linear opacity are the main features in outpatients.Conclusion: BPD patients have a high rate of rehospitalization due to recurrent respiratory tract infection,the main manifestations are cough,short of breath,wheezing,cyanosis,and rales in the lung.Klebsiella pneumoniae and RSV are the main pathogens,and klebsiella pneumoniae producing ESBL has a high incidence,but shows high sensitive to meropenem,imipenem and macrodantin.For patients infected klebsiella pneumoniae in the early time,we should be aware of the recurrent rehospitalization.There is a improvement in CT appearance with time,linear opacity is significantly increased with time.high density opacity and air bronchgram have some value when it comes to distinguish recent airway infection.BPD patients can also die when sever infection happened.