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Study on Common Causes and Clinical Characteristics of the Recurrent Pneumonia on Infants and Children

Author: LeiXiaoYu
Tutor: CuiZhenZe
School: Dalian Medical University
Course: Pediatrics
Keywords: Recurrent Pneumonia Common Causes Clinical Characteristics Gastroesophageal Reflux 24h ph-impedance monitoring
CLC: R725.6
Type: Master's thesis
Year: 2013
Downloads: 9
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Abstract


ObjectiveTo investigate common causes and clinical characteristics of the recurrent Pneumoniaon infants and children; To guide the treatment and improve the prognosis.MethodsRetrospective analysis is conducted in108cases of recurrent pneumonia. The thesisanalyzed and summarized the clinical data of108infants and children with recurrentpneumonia who are hospitalized for treatment in the Pediatric Respiratory InternalMedicine of Dalian Children’s Hospital from February2012to January2013.Results1. Among108cases with recurrent pneumonia, children under1year old are the mostcommon patients, which accounting for40.9%. Male children are in the majority. whichaccounting for64.8%2. In this study,93cases (86.1%) had basic diseases, among which cases withcongenital malformation (including congenital malformation of heart and airwaymalformation) amount to26cases, accounting for28%; airway aspiration (includingGastroesophageal Reflux) amount to24cases, accounting for25.8%; cases withWeakened Immune System amount to20cases, accounting for21.5%; cases withasthma amount to19cases, accounting for20.4%; and cases with other basic diseasesamount to4cases (such as hypohemia, zinc and calcium deficiency, etc.) account for4.3%.3. Among those cases with recurrent pneumonia caused by congenital malformation,CMH (congenital malformation of heart) amount to16cases, accounting for61.5%.Patent Foramen Ovale is the principal type, accounting for31.5%. Other less principal types are followed by the patent ductus arteriosus, ASD and VSD.10cases are theinfants and children with anatomical abnormalities of congenital respiratory system. Asthe principal manifestation, the bronchial stenosis accounts for30%, and others arebronchopulmonary dysplasia, diaphragmatic eventration, isolation of pulmonary,bronchial malformation, etc..4. Among those cases with recurrent pneumonia caused by the airway aspiration,gastroesophageal reflux disease in the first place cause, accounting for50%.853refluxcycle are tested in total,64%for acid reflux,34.6%for weak acid reflux, alkaline refluxnot detected. The ratio of acid reflux to weak acid reflux is1.9to1. Among theabove-mentioned cases, cases with severe reflux are8cases, accounting for72.0%;cases with mild reflux are3cases, accounting for28.0%. There are361times forUpright reflux, accounting for42.3%; Other less principal position are followed byrecumbent position reflux. Acid reflux occurs mainly in the postprandial2hours.Impedance detection:71.7%for mixed reflux,28.2%for liquid reflux. Distalreflux is primary.Reflux indexes of11cases with gastroesophageal reflux werecompared with normal values by test, and the values have statistical significance.5. Among25cases with with Weakened Immune System,52%of the cases are withweakened humoral immunity, and all with IgA declining.48%of the cases are withweakened cellular immunity, with CD4and CD8decreased.Conclusion1. Etiologies of recurrent pneumonia on children are very complicated. The male casesare more common. congenital malformation is the first place etiology, airwayaspirationis the second place etiology,among which the gastroesophageal reflux diseaseis important..2. congenital malformation is primary etiology. CMH (congenital malformation ofheart) amount to61.5%. abnormalities of congenital respiratory system amount to38.5%.3. Appling of24h ph-impedance monitoring technique to detect gastroesophagealreflux on infants and children, the rate of detecting gastroesophageal reflux increased;the reflux can be detected more comprehensively; the reflux types can be analyzed morecomprehensively. The technique is in the leading level in China and is worthstrengthening clinical recommendations and applications.4. Among25cases with with Weakened Immune System,52%of the cases are with weakened humoral immunity, and all with IgA declining.48%of the cases are withweakened cellular immunity, with CD4and CD8decreased.

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