Grazioli Serge, Rougemont Anne-Laure, Ruchonnet-Métrailler Isabelle
Division of Neonatal and Pediatric Intensive Care, Department of Pediatrics, Obstetrics and Gynecology, Geneva University Hospitals, Geneva, Switzerland.
Division of Clinical Pathology, Geneva University Hospitals, Geneva, Switzerland.
Pediatr Cardiol. 2020 Jun;41(5):1071-1073. doi: 10.1007/s00246-020-02368-1. Epub 2020 May 14.
We report the case of a 5-year-old boy who developed chronic plastic bronchitis after Fontan surgery for a complex congenital heart disease. During a new admission for acute exacerbation of plastic bronchitis, he started on a mucolytic treatment with inhaled rhDNAse instead of inhaled fibrinolytics because of the potential bleeding risk in a patient on combined coumarin and aspirin treatment. Respiratory symptoms resolved promptly, and the patient was discharged home on rhDNAse treatment. He remained clinically stable on rhDNAse treatment without further hospitalization until definitive treatment with dynamic lymphangiography and percutaneous embolization.
我们报告了一名5岁男孩的病例，该男孩在接受Fontan手术治疗复杂先天性心脏病后患上了慢性塑料支气管炎。在因塑料支气管炎急性加重再次入院期间，由于该患者正在接受香豆素和阿司匹林联合治疗存在潜在出血风险，因此开始使用吸入性重组人脱氧核糖核酸酶（rhDNAse）进行黏液溶解治疗，而非吸入性纤维蛋白溶解剂。呼吸症状迅速缓解，患者在接受rhDNAse治疗后出院回家。在接受动态淋巴管造影和经皮栓塞的确定性治疗之前，他在rhDNAse治疗下临床状况保持稳定，未再住院。
