摘要
目的探讨纤维支气管镜(纤支镜)术对小儿反复喘息性疾病的诊断及治疗价值。方法收集本院2006年4月-2011年4月因反复喘息住院并应用纤支镜诊疗的72例患儿的临床资料。病例均在局部表面麻醉下行纤支镜术,通过镜下直视、支气管内膜刷检、支气管肺泡灌洗液病原学检查进一步明确病因,行支气管肺泡灌洗及注药等局部治疗,并评判其疗效和并发症发生情况。结果 72例反复喘息患儿镜下表现:支气管内膜炎改变45例(62.5%),支气管异物11例(15.3%),支气管软化10例(13.9%),支气管狭窄4例(5.6%),支气管内膜结核2例(2.8%)。45例患儿支气管肺泡灌洗液病原学检查阳性5例(11.1%),其中肺炎克雷伯杆菌1例,肺炎支原体和支气管内膜结核各2例。镜下炎症改变重、分泌物黏稠、痰栓阻塞患儿经纤支镜支气管冲洗,咳喘明显减轻,取得较好疗效。11例支气管异物经纤支镜成功取出9例。12例行纤支镜术的患儿出现术中或术后轻微一过性并发症,经相应对症处理后均消失。结论小儿反复喘息的病因以炎症、先天性发育异常及呼吸道异物多见,婴幼儿反复喘息应警惕心肺发育异常及呼吸道异物。纤支镜检查对儿童反复喘息的病因诊断具有重要价值。
Objective To explore the clinical value of fiberoptic bronchoscopy in diagnosis and treatment of recurrent wheezing in children.Methods Clinical data of 72 pediatric patients with recurrent wheezing were retrospectively analyzed from Department of Respiratory,Guiyang Children′s Hospital,from Apr.2006 to Apr.2011.Under local anesthesia,fiberoptic bronchoscopy was used to identify the pathogeny with the methods of straight inspect,bronchoalveolar lavage fluid examine,and therapy with bronchoalveolar lavage and inject medicine were performed.Results Through bronchofibroscopy,there were 45 cases with inflammation（62.5%）,11 cases with bronchial foreign bodies（15.3%）,10 cases with bronchomalacia（13.9%）,4 cases with tracheal stenosis（4.6%）,and 2 cases with endobronchial tuberculosis（2.8%）.The positive rate of bronchoalveolar lavage was 11.1%（5/45 cases）,1 case with klebsiella pneumoniae,2 cases with mycoplasma pneumoniae,and 2 cases with endobronchial tuberculosis.Optimal effect was acquired after bronchoalveolar lavage and administration of drug.In 11 patients with airway foreign body,foreign body was removed in 9 patients by fiberoptic bronchoscopy.Some transient and mild complications were observed during and 24 hours after fiberoptic bronchoscopy in 12 cases.Meanwhile,most of complications were slight and transient.All adverse reactions were disappeared after symptomatic therapy.Conclusions Inflammation,airway congenital malformation and bronchial foreign bodies were main reasons for recurrent wheezing.Airway congenital malformation and bronchial foreign bodies must be care of in infants who had recurrent wheezing.Fiberoptic bronchoscopy is useful in the etiologic identification of recurrent wheezing in children.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2012年第4期271-272,282,共3页
Journal of Applied Clinical Pediatrics
基金
贵阳市社会发展领域科技攻关项目(1-社-08号)
关键词
纤维支气管镜
喘息
诊断
治疗
儿童
fiberoptic bronchoscopy wheezing diagnosis treatment child
作者简介
靳蓉，女，主任医师，硕士生导师，研究方向为呼吸系统疾病，电子信箱jinrong2614@sina．com。
