Annals of the Russian academy of medical sciencesAnnals of the Russian academy of medical sciencesВестник Российской академии медицинских наук0869-60472414-3545"Paediatrician" Publishers LLC12310.15690/vramn.v68i11.844PEDIATRICS: CURRENT ISSUESАКТУАЛЬНЫЕ ВОПРОСЫ ПЕДИАТРИИNOSOCOMIAL RESPIRATORY SYNCYTIAL VIRUS BRONCHIOLITIS IN PRETERM INFANTS: CHARACTERISTICS OF THE COURSE, TREATMENT АND PREVENTION IN CLINICAL PRACTICEНОЗОКОМИАЛЬНЫЙ РЕСПИРАТОРНО-СИНЦИТИАЛЬНЫЙ ВИРУСНЫЙ БРОНХИОЛИТ У НЕДОНОШЕННЫХ ДЕТЕЙ: ОСОБЕННОСТИ ТЕЧЕНИЯ, ЛЕЧЕНИЕ И ПРОФИЛАКТИКА В РЕАЛЬНОЙ КЛИНИЧЕСКОЙ ПРАКТИКЕOvsyannikovD. Yu.ОвсянниковД. Ю.
Russian Federation

PhD, Head of the Department of Pediatrics of FSBI People’s Friendship University of Russia. Address: 6, Miklukho-Maklaya Street, Moscow, RF, 117198; tel.: +7 (499) 236-11-52

mdovsyannikov@yahoo.comDegtyarevD. N.ДегтяревД. Н.
Russian Federation

PhD, professor, Deputy Director for Scientific Research of FSBI “V.I. Kulakov Research Center for Obstetrics, Gynecology and Perinatology”.Address: 4, Akad. Oparin Street, Moscow, RF, 117997; tel.: +7 (495) 531-44-44

glav_neolog@yahoo.comRyuminaI. I.РюминаИ. И.
Russian Federation

PhD, professor, Head of the Department of Pathology of Newborns and Premature neonates of FSBI “V.I. Kulakov Research Center for Obstetrics, Gynecology and Perinatology”. Address: 4, Akad. Oparin Street, Moscow, RF, 117997; tel.: +7 (495) 531-44-44

i.ryumina@mail.ruKrsheminskayaI. V.КршеминскаяИ. В.
Russian Federation

assistant of the Department of Pediatrics of FSBI People’s Friendship University of Russia. Address: 6, Miklukho-Maklaya Street, Moscow, RF, 117198; tel.: +7 (499) 154-03-33

spatira@mail.ruOrlovskayaI. V.ОрловскаяИ. В.
Russian Federation

MD, senior research scientist of the Department of Pathology of Newborns and Premature neonates of FSBI “V.I. Kulakov Research Center for Obstetrics, Gynecology and Perinatology”. Address: 4, Akad. Oparin Street, Moscow, RF, 117997; tel.: +7 (495) 531-44-44

secretariat@oparina4.ruRussian Peoples’ Friendship University, Moscow, Russian FederationРоссийский университет дружбы народов, Москва, Российская ФедерацияV.I. Kulakov Scientific Center of Obstetrics, Gynecology and Perinatology, Moscow, Russian FederationНаучный центр акушерства, гинекологии и перинатологии им. акад. В.И. Кулакова, Москва, Российская Федерация121120136811Vestnik Rossiiskoi akademii medetsinskikh nauk / Annals of the Russian academy of medical sciencesВестник Российской академии медицинских наук545907082015Copyright ©; 1970, "Paediatrician" Publishers LLCCopyright ©; 1970, Издательство "Педиатръ"1970"Paediatrician" Publishers LLCИздательство "Педиатръ"https://vestnikramn.spr-journal.ru/jour/about/submissionshttps://vestnikramn.spr-journal.ru/jour/article/view/123

Objective: to study the clinical, laboratory and radiological features of the course of nosocomial bronchiolitis respiratory syncytial viral (RSV ) etiology and effectiveness of the therapy in preterm infants in the neonatal hospital conditions. Patients and Methods: We analyzed case histories of 10 hospitalized patients who had RSV etiology bronchiolitis established by RIF / PCR in neonatal Moscow hospitals in 2011-2013. Results: RSV infection in hospitalized preterm infants with and without bronchopulmonary dysplasia runs hardly, requiring treatment in the intensive care unit, oxygen therapy and lungs mechanical ventilation. The respiratory failure is the symptom of the of RSV bronchiolitis severity. X-ray picture of the disease is characterized by peribronchial changes, emphysematous swelling , segmental infiltration and bronchial obstruction (atelectasis, hypoventilation ). The frequency of bacterial complications of RSV bronchiolitis is low. In clinical practice newborns with severe RSV bronchiolitis are treated with antibiotics, bronchodilators, steroids. The timely isolation of patients can prevent the extention of the infection in the hospital. Conclusions: The preventive measures are needed to prevent the extention of RSV in neonatal hospitals, including specific immune prophylaxisof RSV infection in children at risk .

Цель исследования: изучить клинические, лабораторные и рентгенологические особенности течения нозокомиального бронхиолита респираторно-синцитиально-вирусной (РСВ) этиологии и эффективность проводимой терапии у недоношенных детей в условиях неонатологического стационара. Пациенты и методы: произведен анализ историй болезней 10 госпитализированных пациентов, перенесших бронхиолит РСВ-этиологии, установленной методом РИФ/ПЦР в неонатологических стационарах г. Москвы в 2011–2013 гг. Результаты: РСВ-инфекция у госпитализированных недоношенных детей с и без бронхолегочной дисплазии протекает тяжело, требуя лечения в условиях отделения реанимации и интенсивной терапии, назначения оксигенотерапии и проведения искусственной вентиляции легких. Тяжесть течения РСВ-бронхиолита определяется дыхательной недостаточностью. Рентгенологическая картина заболевания характеризуется перибронхиальным изменениями, эмфизематозным вздутием, сегментарной инфильтрацией и нарушением бронхиальной проходимости (ателектаз, гиповентиляция). Частота бактериальных осложнений при РСВ-бронхиолите невелика. В реальной клинической практике новорожденным с тяжелым течением РСВ-бронхиолита назначаются антибиотики, бронхолитики, стероиды. Предотвращению распространения инфекции в стационаре может способствовать своевременная изоляция больных. Выводы: необходимы профилактические мероприятия для предотвращения распространения РСВ в неонатологических стационарах, в т.ч. специфическая иммунопрофилактика РСВ-инфекции у детей групп риска.

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