milk aspiration pneumonia
Introduction
Introduction to milk aspiration pneumonia Milk aspiration pneumonia (milkaspirationpneumonia) is caused by the milk being inhaled into the respiratory tract during swallowing or due to prolonged emptying of the pharynx, and the residual milk is inhaled into the lungs. When vomiting or galactorrhea, milk is inhaled into the respiratory tract, often with incentives. basic knowledge The proportion of illness: 0.3% Susceptible people: infants and young children Mode of infection: non-infectious Complications: neonatal asphyxia, pulmonary fibrosis, bronchiectasis, respiratory failure, heart failure, interstitial pneumonia
Cause
Causes of milk aspiration pneumonia
Dysphagia (30%):
Immature swallowing reflex immature, inconsistent swallowing action, prone to milk inhalation, brain injury or cranial neuropathy can also make swallowing reflexes incomplete or incomplete, milk in the pharyngeal emptying time prolonged, sometimes due to pharyngeal nerve muscles Coordination, when the swallowing part of the milk enters the esophagus, part of it flows out of the nasal cavity, and part of it inhales into the respiratory tract, causing pneumonia.
Esophageal malformation (30%):
When the esophagus is locked, the milk can not enter the stomach from the esophagus, and stays in the pharynx and saliva together into the lungs. Only the tracheal esophagus can directly enter the lungs through the fistula, but sometimes the fistula is small and difficult to find.
Esophageal insufficiency (30%):
After the milk enters the esophagus, it flows back to the pharynx and then inhales. For example, a baby with a relaxed esophageal sputum is prone to inhalation after vomiting, and sometimes it can cause reflux due to coordination of the esophagus and neuromuscular.
Severe cleft palate (5%):
Rabbit cleft lip and palate generally does not affect swallowing, but severely deficient people have difficulty in sucking milk and can cause inhalation.
When the milk inhaled into the alveoli, the lung tissue showed an inflammatory reaction. After a few hours, there were neutrophils, phagocytic cells and red blood cells exuded, the alveolar wall thickened, interstitial inflammation was obvious, and fibrosis appeared several weeks later, such as repeated inhalation. Chronic interstitial pneumonia.
Prevention
Milk aspiration pneumonia prevention
In order to avoid breast aspiration pneumonia, when feeding premature and low birth weight infants, pay attention to the position of breastfeeding, follow the principle of raising the bed and breastfeeding according to the amount. Generally speaking, the body weight is less than 1500 grams, swallowing reflex Poor infants should be fed with nasal feeding until the swallowing reaction is corrected, and then fed with teats. For children with gastrointestinal malformations, they should go to the hospital for surgery as soon as possible to avoid undue consequences.
Complication
Larval aspiration pneumonia complications Complications neonatal asphyxia pulmonary fibrosis bronchiectasis respiratory failure heart failure interstitial pneumonia
Often complicated by bronchitis, pneumonia, or even suffocation, long-term reflux inhalation, resulting in interstitial pneumonia, pulmonary fibrosis and bronchiectasis, severe respiratory failure and heart failure.
Symptom
Symptoms of milk aspiration pneumonia Common symptoms Cough and irritating milk Newborn gas-induced lung texture thickening pulmonary fibrosis suffocation
1, the symptoms of the primary disease causing inhalation
If the baby's milk from swallowing dysfunction flows out of the nasal cavity, coughing occurs at the same time, cyanosis is sometimes present, and the baby with a blind end of the esophagus is stuck in the throat of the esophagus, and there is a voice during breathing. The esophageal tracheal fistula is coughing when feeding, and the wind is short. And cyan, the esophageal dysfunction is easy to galactorrhea.
2, respiratory symptoms and signs
Severity is related to the amount and frequency of inhalation. Inhalation is small or accidental inhalation is mainly bronchitis. Symptoms include cough, asthma, and shortness of breath. When a large amount of inhalation occurs, pneumonia may occur, and a large amount of inhalation may cause asphyxia and stop breathing. After resuscitation, there was obvious shortness of breath, and there were many rales in the lungs. Pyogenic pneumonia occurred in long-term inhalation, which eventually led to pulmonary fibrosis or complicated bronchiectasis.
3, X-ray performance
In the early stage, due to foreign body stimulation of the bronchus, paralysis occurred, not completely obstructed. X-ray showed extensive emphysema and bronchial inflammation, widening of the hilar shadow, thickening of the lung texture or inflammation of the patch, repeated inhalation involving Interstitial, forming interstitial pneumonia.
Examine
Examination of milk aspiration pneumonia
1, peripheral blood leukocytosis, neutrophils increased, those with cyanosis should be followed up for blood gas examination.
2, X-ray performance: early due to foreign body stimulation of the bronchial, paralysis, not completely obstructed, X-ray showed extensive emphysema and bronchitis, lung enlargement, lung texture thickening or inflammation spots The film, repeated inhalation involving the interstitial, forming interstitial pneumonia.
Diagnosis
Diagnosis and identification of milk aspiration pneumonia
1, diagnosis
Diagnosis can be performed based on clinical manifestations and examinations.
2, differential diagnosis
Identification with infectious bronchitis, pneumonia, especially the history of inhalation is not clear, pay attention to the identification when the amount of inhalation is small, pay attention to cough, the relationship between cyanosis and eating, etc. to help identify.
