Buradasınız

Anasayfa » Content

KRONİK ÖKSÜRÜKLÜ ÇOCUKLARDA FLEKSİBLE BRONKOSKOPİ BULGULARI

THE FLEXIBLE BRONCHOSCOPY FINDINGS OF CHILDREN WHO HAVE CHRONIC COUGH

Journal Name:

  • Selçuk Tıp Dergisi

Publication Year:

  • 2008

Key Words:

Keywords (Original Language):

Author NameUniversity of Author
Abstract (2. Language): 
Aim: Coughing is a common symptom in childhood. The cough last for over 4 to 6 weeks and also which makes patients the family and the doctor feel discomfort is called chronic cough. If this cough last long and repeats, it has to be investigated. After a detailed history and physical examination, distinctive studies have to be made. The purpose of this study is to evaluate the patients, which have been made flexible bronchoscopy because of chronic cough, by their clinical, laboratory and bronchoscopic findings. Material and Method: In this study we evaluated 23 patients with chronic cough; which were examined between January 2002 and December 2006 in Pediatric Chest Unit of Hacettepe University. Patients have cough for over 4 to 6 weeks, without specific chest X Ray findings, gastroesophageal reflux and problem with their immunologic system were and because of all these reasons they have been made bronchoscopy. The patients files are analyzed retrospectively by their demographic, clinic and bronchoscopic findings. Results: The study consisted of 23 patients: (12 males/11 females). The age of the patients vary between 1 and 13,8 years (mean age: 5 years). All patient’s radiological findings were normal without one patient. This patient’s have bronchial abnormalities in sanal bronchoscopy. When it is observed with flexible bronchoscopy ten patients have abnormal findings. Two patients have foreing body aspiration in their left main bronchus, two patients have tracheomalasia, three patients have hyperemia and secretions infection and two have bronchial abnormalites.In six patients’ bronchoalveolar lavage microorganism grew. Three patients have lipid laden macrophage and two patients whose previous gastroesophageal reflux scintigraphie were negative then found in and started treatment Conclusion: Although flexible bronchoscopy is an invasive technique, it evaluates respiratory system’s functional, anatomic characteristics well and it is a valuable technique in finding the etiology of chronic cough.
Bookmark/Search this post with
Abstract (Original Language): 
Amaç: Kronik öksürük, çocukluk ça¤›nda s›k karfl›lafl›lan, hasta ve aileyle birlikte hekimi de huzursuz eden bir bulgudur. Bu çal›flman›n amac›; merkezimizde kronik öksürük nedeni ile araflt›r›lan ve fleksible bronkoskopi (FB) yap›lan hastalar›n klinik, laboratuar ve bronkoskopik bulgular aç›s›ndan de¤erlendirilmesidir. Gereç ve Yöntem: Hacettepe Çocuk Gö¤üs Hastal›klar› Ünitesinde Ocak 2002- Aral›k 2006 tarihleri aras›nda kronik öksürük nedeniyle izlenen, 4-6 haftadan beri öksürü¤ü olan, akci¤er grafi bulgular› spesifik olmayan bu nedenle FB yap›lan 23 hasta çal›flmaya al›nd›. Hastalar›n dosyalar› retrospektif olarak demografik, klinik ve bronkoskopik bulgular aç›s›ndan incelendi. Gastroözofagial reflü veya immün yetmezli¤i olan hastalar çal›flmadan ç›kar›ld›. Bulgular: Kronik öksürük nedeniyle bronkoskopi yap›lan 23 hastan›n 12’i erkek, 11’i k›zd›. Yafllar› 1-13,8 y›l aras›nda de¤ifliyordu. Ortalama yafl 5 y›l idi. Bir hasta hariç tüm hastalar›n radyolojik incelemesi normaldi. Bir hastada sanal bronkoskopide bronfl anomalisi saptand›. Yirmi üç hastan›n FB ile de¤erlendirilmesinde 10 hastada normalin d›fl›nda bulgu saptand›. ‹ki hastada sol ana bronflta yabanc› cisim ve granülasyon dokusu, 2 hastada trakeomalazi, 3 hastada enfeksiyonla uyumlu olan hiperemi ve sekresyon, 1 hastada mantar enfeksiyonu düflündüren trakeada beyaz plaklar saptand›. ‹ki hastada ise bronfl anomalisi saptand›. Fleksible bronkoskopi de patoloji tesbit edilen hastalar›n 6’›nda da BAL kültürlerinde üreme tesbit edildi. Üç hastada Bronkoalveolar lavaj (BAL) da lipid yüklü makrofaj tesbit edildi ve daha önce gastroözofageal reflü (GÖR) sintigrafisi normal olan iki hastan›n tekrarlanan GÖR sintigrafisi pozitif olarak bulunup reflü tedavisi baflland›. Sonuç: Fleksible bronkoskopi invaziv bir giriflim olmas›na ra¤men solunum sisteminin fonksiyonel, anotomik özelliklerini iyi de¤erlendiren, kronik öksürükte nedeni ayd›nlatmakta tan›ya yard›mc› bir yöntemdir.
FULL TEXT (PDF): 
PDF icon arastirmax-kronik-oksuruklu-cocuklarda-fleksible-bronkoskopi-bulgulari.pdf
  • 4
183-189
  • Turkish

REFERENCES

References: 

1. Chang A B, Glomb W B. Guidelines for evaluating
chronic chough in pediatrics: ACCP evidence- based
clinical practical guidelines. Chest. 2006; 129: 260-
83.
2. Marchant JM, Masters IB, Taylor SM, Cox NC,
Seymour GJ, Chong AB, et all. Evaluation and outcome of young children with chronic cough. Chest.
2006; 129:1132-41
3. Anne B. Chang The physiology of cough Paediatr
Respir Reviews. 2006;7: 2-8.
4. John Massie. Cough in children: when does it matter? Paediatr Respir Reviews. 2006;7: 9-14.
5. Irwin RS, Boulet LP, Cloutier MM, Fuller, RJ, Gold PM,
Hoffstein V. et al. Managing cough as a defense
mechanism and as a symptom. A consensus panel
report of the American College of Chest Physicians.
Chest. 1998; 114: 133-81.
6. Morice AH and committee members. The diagnosis
and management of chronic cough. Eur Respir J.
2004; 24: 481-92.
7. Irwin RS, Madison JM. The diagnosis and treatment
of cough. N Eng J Med. 2000; 343: 1715-21
8. Mc Garvey LPA. Cough 6: Which investigations are
most useful in the diagnosis of chronic cough.
Thorax. 2004; 59: 342-6
9. Kogan MD, Pappas G, Yu SM, Kotelchuck M. Overthe-counter medication use among US preschoolage children. JAMA. 1994;272:1025-30.
10. Dockery D W, Gold D R, Rotntsky A. Effects of age,
sex and race on prevalence of respiratory symptoms
among children. Am Rev Respir Dis. 1989; 139:
A23,
11. Donnelly D, Critchlow A, Everard ML. Outcomes in
children treated for persistent bacterial bronchitis.
Thorax. 2007; 62:80-4
12. Nicolai T. Pediatric broncoskopy. Pediatr Pulmonol
2001; 31: 150-64
13. Even L, Heno N, Talmon Y, Samet E, Zonis Z,
Kugelman A. Diagnostic evaluation of foreign body
aspiration in children: a prospective study. J Pediatr
Surg. 2005 Jul;40(7):1122-7
14. Zerella JT, Dimler M, McGill LC, Pippus KJ. Foreign
body aspiration in children: value of radiography
and complications of bronchoscopy. J Pediatr Surg.
1998; 33:1651-4.
15. Chiu CY, Wong KS, Lai SH, Hsia SH, Wu CT. Factors
predicting early diagnosis of foreign body aspiration
in children. Pediatr Emerg Care. 2005;21:161-4
16. Kiyan G, Uygun I, Karada¤ B, Tu¤tepe H, Iskit SH,
Da¤li TE. Foreign body aspiration in children. Kulak
Burun Bogaz Ihtis Derg. 2004;12(5-6):128-33
17. Hui H, Na L, Zhijun CJ, Fugao ZG, Yan S, Niankai
ZK, et all. Therapeutic experience from 1428
patients with pediatric tracheobronchial foreign
body. J Pediatr Surg. 2008;43:718-21.
18. Skoulakis CE, Doxas PG, Papadakis CE, Proimos E,
Christodoulou P, Bizakis JG, et all. Bronchoscopy for
foreign body removal in children. A review and
analysis of 210 cases. Int J Pediatr Otorhinolaryngol.
2000 Jun 30;53(2):143-8
19. Karakoc F, Cakir E, Ersu R, Uyan ZS, Colak B,
Karadag B, et all. Late diagnosis of foreign body
aspiration in children with chronic respiratory symptoms. Int J Pediatr Otorhinolaryngol. 2007
Feb;71(2):241-6. Epub 2006 Nov 27
20. Fitch PS, Brown V, Schock BC, Taylor R, Enis M,
Shields MD. Chronic cough in children.
Bronchoalveolar lavage findings. Eur Respir J. 2000;
16:1109-14
21. Colombo JL, Hallberg TK. Pulmonary aspiration and
lipid-laden macrophages: in search of gold (standards). Pediatr Pulmonol 1999; 28: 79-82
22. Snijders D, Cattarozzi A, Panizzolo C, Zanardo V,
Guariso G, Calabrese F, et all. Investigation of children with chronic nonspecific cough: any clinical
benefit of bronchoscopy and bronchoalveolarlavage? Allergy Asthma Proc. 2007;24:462-7
23. Schellhase DE, Fawcett DD, Schutze GE, Lensing SY,
Tryka AF. Clinical utility of flexible bronchoscopy and
bronchoalveolar lavage in young children with
recurrent wheezing. J Pediatr 1998; 132: 312-8
24. Knauer-Fisher S, Ratjen F. Lipid-laden macrophages
in bronchoalveolar lavage fluid as a marker for pulmonary aspiration. Pediatr Pulmonol 1999; 27: 419-
22.
25. Bauer ML, Lyrene RK. Chronic aspiration in children:
evaluation of the lipid-laden macrophage index.
Pediatr Pulmonol 1999; 28: 94-100
26. Irwin RS, Curley FJ, French CL. Chronic cough. The
spectrum and frequency of causes, key components
of the diagnostic evaluation, and outcome of specific therapy. Am Rev Respir Dis 1990; 141: 640-7.
27. Chang AB, Redding GJ, Everard ML. Chronic wet
cough: Protracted bronchiectasis. Pediatr Pulmonol.
2008; 43:519-31.
28. Bush A. Paediatric problems of cough. Pulmonary
Pharmacology Therapeutics.2002; 15:309-15
29. Boogaard R, Huijsmans SH, Pijnenburg MW,
Tiddens HA, de Jongste JC, Merkus PJ.
Tracheomalacia and bronchomalacia in children:
incidence and patient characteristics. Chest. 2005
Nov;128(5):3391-7

Thank you for copying data from http://www.arastirmax.com