纤维支气管镜在儿童肺不张病因诊断及治疗中的应用  

Application of fiberoptic bronchoscopy in the etiological diagnosis and treatment of atelectasis in children

作　　者：杨泽玉[1,2] 刘文君[3] 魏文[3] 

机构地区：[1]安徽医科大学第一附属医院儿科,合肥230001 [2]安徽省立儿童医院呼吸科 [3]安徽省立儿童医院儿科,合肥230051

出　　处：《中国小儿急救医学》2007年第1期21-23,共3页Chinese Pediatric Emergency Medicine

摘　　要：目的探讨纤维支气管镜在儿童肺不张病因诊断及治疗中的应用价值。方法回顾分析我院经一般治疗无效而行纤维支气管镜检查的40例肺不张患儿的临床资料。结果40例中以炎症最多见，共21例，占52．5％；其次为异物10例，占25．0％；支气管扩张3例，占7．5％，居第三位。肺不张发生率右肺高于左肺。炎性肺不张以右中叶最多，占71．4％；异物所致肺不张以下叶为多，且多发生在1～3岁的幼儿；支气管扩张所致肺不张多发生在较大儿童。经支气管肺泡灌洗治疗37例（有异物者予异物取出术）。部分或完全复张者31例，复张率达83．8％。结论小儿肺不张病因中以炎症、异物、支气管扩张最多见；纤维支气管镜检查不仅能最大限度地帮助明确肺不张病因，而且在小儿肺不张的治疗中有重要作用。Objective To explore the diagnostic and therapeutic value of fiberoptic bronchoscopy in children with atelectasis. Methods The clinical data of 40 atelectasis cases performed by fiberoptic bronchoscopy were analyzed retrospectively. Results Among the 40 atelectasis cases, inflammation, totaling 21 cases （52.5 % ）, was the leading cause, which was followed by foreign body （10/40, 25.0 % ） and bronchiectasis （3/40, 7.5 % ）. The incidence of atelectasis in right lung was significantly higher than that in the left lung. Inflammatory atelectasis （71.4%） was most common in the right middle lobe;foreign body was most commonly seen in atelectasis of the lower lobe, peaking during 1 - 3 years. The atelectasis caused by bronchiectasis was usually found in elder children. Thirty-one of 37 cases treated by bronchial lavage were cured or improved, showing the re-expansion rate as high as 83.8 %. Conclusion Inflammation, foreign body, bronchiectasis are the leading causes of atelectasis in children. Fiberoptic bronchoscopy is useful for not only etiological diagnosis but also atelectasis treatment in children.

关 键 词：纤维支气管镜检查术 肺不张 病因 治疗 儿童 

分 类 号：R72[医药卫生—儿科]