CURRENT ISSUES OF CHRONIC NONSPECIFIC LUNG DISEASES IN CHILDREN
This article represents the results of long-term observations, devoted to the problems of chronic non-specific pulmonary diseases (CNPD) in children. In dynamics, for the period 2007-2017, high morbidity and invalidation levels were registered. For the improvement of treatment quality and regular check-in definite estimation of CNPD structure is necessary. Well-time diagnostic of the concrete clinical variant and individual approaches are very important in such patients. The main risk factors for the formation and structure of CNPD in children were studied. The main group of 522 cases (45.8%) consisted of patients with lung malformations complicated by secondary bacterial process. On the basis of clinical and morphological comparisons, there was noted the possibility of developing tissue dysplasia in children, not provided by the approved classification of clinical forms of bronchopulmonary diseases in children. It is also noted that disorders of lung growth and development in children with secondary forms of CNPD, along with defects in the development of anatomical structures, are accompanied by the formation of interstitial processes in the lungs. Different clinical variants of CNPD in children as outcomes of bronchopulmonary dysplasia were noted in 22.8% of cases. There were studied possible causes of the formation of conditionally primary chronic forms of CNPD (23.7% of observations) as the outcome of complicated forms of community-acquired pneumonia, taking into account genetically determined predisposition to chronization of the process, the peculiarity of immune intercellular interactions, disturbance of energy supply of immunocompetent blood cells, the formation of tissue dysplasia of pulmonary tissue. Genetically determined lung diseases were identified in 7.7% of cases. Children with allergic lung diseases and hereditary diseases were not included in the development. The presented structure of CNPD in children is due to the regional peculiarity of hospitalized children, possibly underdiagnosed genetically determined lung diseases. The etiological structure of CNPD was studied, which determines the possibility of targeted antibiotic therapy and specific immunotherapy. The effectiveness of treatment and quality of life depends on the quality of topical diagnosis, clinical, etiological variant of CNPD in children.