fa نقش یافتههای آزمایشگاهی در تشخیص، درمان و پیش آگهی برونشیولیت عمومى General پژوهشي Research <span style="font-size:12.5pt"><span style="line-height:17pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span b="" mitra="" style="font-family:"><span style="color:black"><b><span lang="FA" style="letter-spacing:-.1pt">زمینه:</span></b><span lang="FA" style="letter-spacing:-.1pt">&nbsp; برونشیولیت حاد شایعترین علت عفونت دستگاه تنفسی تحتانی و بیشترین عامل بستری شدن به علت بیماری تنفسی در دوران شیرخوارگی است. تشخیص این بیماری عمدتاً از طریق معاینه بالینی و شرح</span><span calibri="" dir="LTR" style="font-family:"><span style="letter-spacing:-.1pt">‌</span></span><span lang="FA" style="letter-spacing:-.1pt">حال بوده و روش</span><span calibri="" dir="LTR" style="font-family:"><span style="letter-spacing:-.1pt">‌</span></span><span lang="FA" style="letter-spacing:-.1pt">های پاراکلینیک در تشخیص بیماری ارزش چندانی ندارند. مطالعه حاضر با هدف تعیین تأثیر انجام آزمایشهای پاراکلینیک و نتایج آنها در مدیریت و درمان کودکان با برونشیولیت حاد انجام شد.&nbsp; </span></span></span></span></span></span></span><br> <span style="font-size:12.5pt"><span style="line-height:17pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span b="" mitra="" style="font-family:"><span style="color:black"><b><span lang="FA" style="letter-spacing:-.1pt">روش کار:</span></b><span lang="FA" style="letter-spacing:-.1pt"> در این مطالعه مقطعی گذشته</span><span calibri="" dir="LTR" style="font-family:"><span style="letter-spacing:-.1pt">‌</span></span><span lang="FA" style="letter-spacing:-.1pt">نگر، پرونده بیماران 1-24 ماهه که در سال</span><span calibri="" dir="LTR" style="font-family:"><span style="letter-spacing:-.1pt">‌</span></span><span lang="FA" style="letter-spacing:-.1pt">های 1397 و 1398 با تشخیص اولیه برونشیولیت در بیمارستان کودکان بهرامی بستری شده</span><span calibri="" dir="LTR" style="font-family:"><span style="letter-spacing:-.1pt">‌</span></span><span style="letter-spacing:-.1pt"> بودند، بررسی شدند. داده</span><span calibri="" dir="LTR" style="font-family:"><span style="letter-spacing:-.1pt">‌</span></span><span lang="FA" style="letter-spacing:-.1pt">های دموگرافیک، بالینی، آزمایشگاهی و همچنین داده های مرتبط با مدیریت بیماری گزارش شدند و ارتباط نتایج آزمایشات با درمان، پیش آگهی و مدت بستری از طریق روش</span><span calibri="" dir="LTR" style="font-family:"><span style="letter-spacing:-.1pt">‌</span></span><span lang="FA" style="letter-spacing:-.1pt">های آماری مورد تجزیه و تحلیل قرار گرفت. </span></span></span></span></span></span></span><br> <span style="font-size:12.5pt"><span style="line-height:17pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span b="" mitra="" style="font-family:"><span style="color:black"><b><span lang="FA" style="letter-spacing:-.1pt">یافته</span></b><b><span calibri="" dir="LTR" style="font-family:"><span style="letter-spacing:-.1pt">‌</span></span><span lang="FA" style="letter-spacing:-.1pt">ها:</span></b><span lang="FA" style="letter-spacing:-.1pt"> پرونده 193 بیمار (4/55</span><span class="latin" new="" roman="" style="font-family:" times=""><span dir="LTR" style="font-size:10.0pt">%</span></span><span style="letter-spacing:-.1pt"> پسر، 6</span><span class="latin" new="" roman="" style="font-family:" times=""><span dir="LTR" style="font-size:10.0pt">/</span></span><span lang="FA" style="letter-spacing:-.1pt">44</span><span class="latin" new="" roman="" style="font-family:" times=""><span dir="LTR" style="font-size:10.0pt">%</span></span><span style="letter-spacing:-.1pt"> دختر، میانگین سنی 17</span><span class="latin" new="" roman="" style="font-family:" times=""><span dir="LTR" style="font-size:10.0pt">/</span></span><span lang="FA" style="letter-spacing:-.1pt">5</span><span class="latin" new="" roman="" style="font-family:" times=""><span dir="LTR" style="font-size:10.0pt"><span calibri="" style="font-family:">&plusmn;</span></span></span><span lang="FA" style="letter-spacing:-.1pt">88</span><span class="latin" new="" roman="" style="font-family:" times=""><span dir="LTR" style="font-size:10.0pt">/</span></span><span lang="FA" style="letter-spacing:-.1pt">3 ماه) بررسی شد. سلولهای خونی</span><span class="latin" new="" roman="" style="font-family:" times=""><span lang="FA" style="font-size:10.0pt">،</span></span><span class="latin" new="" roman="" style="font-family:" times=""><span dir="LTR" style="font-size:10.0pt">CRP </span></span><span lang="FA" style="letter-spacing:-.1pt">و الکترولیتهای سرم (سدیم و پتاسیم) در بیش از 90</span><span class="latin" new="" roman="" style="font-family:" times=""><span dir="LTR" style="font-size:10.0pt">%</span></span><span style="letter-spacing:-.1pt"> بیماران، کشت خون و کشت ادرار در 50</span><span class="latin" new="" roman="" style="font-family:" times=""><span dir="LTR" style="font-size:10.0pt">%</span></span><span lang="FA" style="letter-spacing:-.1pt">&nbsp; و آنالیز گازهای خون در 65</span><span class="latin" new="" roman="" style="font-family:" times=""><span dir="LTR" style="font-size:10.0pt">%</span></span><span style="letter-spacing:-.1pt"> اندازه گیری شد. در همه موارد الکترولیت ها در طیف طبیعی قرار داشتند. آنالیز ادراری در 1</span><span class="latin" new="" roman="" style="font-family:" times=""><span dir="LTR" style="font-size:10.0pt">/</span></span><span lang="FA" style="letter-spacing:-.1pt">2 </span><span class="latin" new="" roman="" style="font-family:" times=""><span dir="LTR" style="font-size:10.0pt">%</span></span><span style="letter-spacing:-.1pt"> کل جمعیت مورد مطالعه مثبت بود که همگی کشت ادراری منفی داشتند و کشت خون در تمامی موارد منفی گزارش شد. یک سوم بیماران حداقل یک نوع آنتی</span><span calibri="" dir="LTR" style="font-family:"><span style="letter-spacing:-.1pt">‌</span></span><span lang="FA" style="letter-spacing:-.1pt">بیوتیک و7</span><span class="latin" new="" roman="" style="font-family:" times=""><span dir="LTR" style="font-size:10.0pt">/</span></span><span lang="FA" style="letter-spacing:-.1pt">92</span><span class="latin" new="" roman="" style="font-family:" times=""><span dir="LTR" style="font-size:10.0pt">%</span></span><span style="letter-spacing:-.1pt"> موارد ونتولین دریافت کردند. اکثریت (3</span><span class="latin" new="" roman="" style="font-family:" times=""><span dir="LTR" style="font-size:10.0pt">/</span></span><span lang="FA" style="letter-spacing:-.1pt">93</span><span class="latin" new="" roman="" style="font-family:" times=""><span dir="LTR" style="font-size:10.0pt">%)</span></span><span style="letter-spacing:-.1pt"> بیماران با تشخیص نهایی برونشیولیت ترخیص شدند و میانگین مدت</span><span calibri="" dir="LTR" style="font-family:"><span style="letter-spacing:-.1pt">‌</span></span><span lang="FA" style="letter-spacing:-.1pt">زمان بستری بیماران 6</span><span class="latin" new="" roman="" style="font-family:" times=""><span dir="LTR" style="font-size:10.0pt">/</span></span><span lang="FA" style="letter-spacing:-.1pt">2 روز بود. بین نتایج آزمایش بیماران با نیاز بیمار به بستری در </span><span class="latin" new="" roman="" style="font-family:" times=""><span dir="LTR" style="font-size:10.0pt">PICU</span></span><span style="letter-spacing:-.1pt"> و مدت</span><span calibri="" dir="LTR" style="font-family:"><span style="letter-spacing:-.1pt">‌</span></span><span lang="FA" style="letter-spacing:-.1pt">زمان بستری بیماران رابطه آماری معنی</span><span calibri="" dir="LTR" style="font-family:"><span style="letter-spacing:-.1pt">‌</span></span><span lang="FA" style="letter-spacing:-.1pt">داری وجود نداشت.</span></span></span></span></span></span></span><br> <span style="font-size:12.5pt"><span style="line-height:17pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span b="" mitra="" style="font-family:"><span style="color:black"><b><span lang="FA" style="letter-spacing:-.1pt">نتیجه</span></b><b><span calibri="" dir="LTR" style="font-family:"><span style="letter-spacing:-.1pt">‌</span></span><span lang="FA" style="letter-spacing:-.1pt">گیری:</span></b><span lang="FA" style="letter-spacing:-.1pt"> یافته</span><span calibri="" dir="LTR" style="font-family:"><span style="letter-spacing:-.1pt">‌</span></span><span lang="FA" style="letter-spacing:-.1pt">های این پژوهش نشان داد که آزمایش</span><span calibri="" dir="LTR" style="font-family:"><span style="letter-spacing:-.1pt">‌</span></span><span lang="FA" style="letter-spacing:-.1pt">ها و درمان</span><span calibri="" dir="LTR" style="font-family:"><span style="letter-spacing:-.1pt">‌</span></span><span lang="FA" style="letter-spacing:-.1pt">های غیرمتناسب با گایدلاین های طب اطفال در حجم وسیعی در برونشیولیت به کار گرفته می</span><span calibri="" dir="LTR" style="font-family:"><span style="letter-spacing:-.1pt">‌</span></span><span lang="FA" style="letter-spacing:-.1pt">شوند و نقش تعیین کننده ای در پیش آگهی و مدیریت بیماری ندارند.</span></span></span></span></span></span></span><br> &nbsp; <span style="font-size:12pt"><span style="line-height:13pt"><span style="font-family:IRMitra"><span style="color:black"><span style="font-weight:bold"><span new="" roman="" style="font-family:" times="">Abstract</span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:13pt"><span style="font-family:IRMitra"><span style="color:black"><span style="font-weight:bold"><span new="" roman="" style="font-family:" times="">Background: Acute bronchiolitis is the most common cause of lower respiratory tract infection and hospitalization due to respiratory disease during infancy. The disease is mainly diagnosed based on history and clinical examination, with paraclinical investigation being of little value in the diagnosis. The present study aimed to determine the role of paraclinical tests in the management and treatment of children with acute bronchiolitis. </span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:13pt"><span style="font-family:IRMitra"><span style="color:black"><span style="font-weight:bold"><span new="" roman="" style="font-family:" times="">Methods: In this retrospective cross-sectional study, the medical records of infants aged 1-24 months admitted to Bahrami Children&rsquo;s Hospital with initial diagnosis of bronchiolitis were reviewed. Demographic, clinical and laboratory data as well as data related to disease management were reported and the relationship between tests&rsquo; results and treatment, prognosis and length of hospital stay was analyzed by statistical methods.</span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:13pt"><span style="font-family:IRMitra"><span style="color:black"><span style="font-weight:bold"><span new="" roman="" style="font-family:" times="">Results: The records of 193 patients (55.4% male, mean age 3.88 &plusmn; 5.17 months) were reviewed. Complete Blood cells (CBC), C-reactive protein (CRP) and serum electrolytes (sodium and potassium) were measured in more than 90% of patients, blood culture and urine culture were performed in 50% and blood gas analysis in 65%. Serum electrolytes were in the normal range in all infants. Blood culture was negative in all patients. Active urine analysis was reported in 2.1% which revealed negative results on urine culture. One-third of patients received at least one type of antibiotic and 92.7% received ventolin. The majority (93.3%) of patients were discharged with a final diagnosis of bronchiolitis and the mean length of hospital stay was 2.6 days. There was no statistically significant relationship between laboratory results and PICU admission and length of hospital stay.</span></span></span></span></span></span><br> <span style="font-size:11.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">Conclusion: The findings of this study showed that laboratory tests and treatments incompatible with pediatric guidelines are widely used in bronchiolitis and do not play a decisive role in the prognosis and management of the disease</span></span></span> برونشیولیت, پیش آگهی, درمان, دستورالعمل بالینی Bronchiolitis, Laboratory, Treatment, Guideline, prognosis 171 175 http://jmciri.ir/browse.php?a_code=A-10-1-2676&slc_lang=fa&sid=1 مهدیه موسوی ترشیزی 10031947532846006607 10031947532846006607 Yes بیمارستان بهرامی پیمان صادقی 10031947532846006608 10031947532846006608 No بیمارستان بهرامی محدثه بیات 10031947532846006609 10031947532846006609 No بیمارستان بهرامی