Chronic bronchopulmonary diseases in children with bronchial obstruction syndrome

Abstract

Introduction. The results of long-term observations of children with chronic bronchopulmonary diseases occurring with bronchoobstructive syndrome and poorly responding to standard therapy are presented. To optimize treatment, it is necessary to accurately determine the nosological variant of the pathology, to identify the main causes of the formation of dysontogenetic disorders.Aim. To study the main nosological options and clinical and diagnostic criteria for chronic obstructive pulmonary diseases in children to justify an individual approach to treatment and follow-up.Materials and methods. 148 children with chronic bronchopulmonary diseases occurring with bronchial obstruction syndrome (excluding bronchial asthma and cystic fibrosis) were exаmined according to the differential diagnostic algorithm developed by us, including anamnestic, clinical, X-ray, functional and morphological methods.Results. The main group of 148 cases consisted of 73 children (49,3%) with lung malformations with insufficiency of the muscular-elastic and cartilaginous framework of the trachea and bronchi, local malformations, with impaired lung growth and development, causing bronchial obstruction. Acquired variants of chronic obstructive pulmonary diseases in children were noted by us in the form of chronic obstructive bronchitis (25.2%) and in the outcome of bronchopulmonary dysplasia (11.5%), chronic obliterating bronchiolitis (6.1%), gastroesophageal reflux disease (0.7%). Acquired local forms of obstruction (foreign object, scar stenosis, tumors) were noted in 4.5% of cases. Hereditary lung diseases, including primary ciliary dyskinesia, were detected in 2.7% of cases.Conclusion. Chronic obstructive pulmonary diseases are diseases of various etiology and pathogenesis that occur at an early age in children with perinatal disorders against the background of various lung malformations, bronchial dysplasia, lung tissue malformations and are the pathomorphological basis for the further formation of chronic obstructive pulmonary disease in adult patients.