无痛性纤维支气管镜术在儿科难治性肺部疾病中的应用  

Non-pain flexible fiberoptic bronchoscopy in children with refractory pulmonary disorders

作　　者：梁慧[1] 田曼[1] 韩青[1] 姚劲[1] 赵德育[1] 

机构地区：[1]南京医科大学附属南京市儿童医院呼吸科,江苏南京210008

出　　处：《临床儿科杂志》2009年第1期26-29,共4页Journal of Clinical Pediatrics

摘　　要：目的探讨无痛性纤维支气管镜(纤支镜)术在儿童难治性肺部疾病诊治中的应用。方法回顾分析221例行纤维支气管镜术患儿的临床资料,全部病例均采用异丙酚静脉复合麻醉。结果221例患儿共行241例次纤支镜术。75例反复或持续喘息的患儿中气管支气管软化、狭窄30例(40.0%),炎性渗出、黏液栓子堵塞26例(34.7%),气道发育畸形9例(12.0%)。72例肺不张患儿中炎症49例(68.1%),气道异常23例(31.9%)。经局部灌洗及用药,68例术后复查,1个月内部分或完全复张57例(83.8%),3个月内复张63例(92.7%)。17例气道异物中经纤支镜取出11例,仅6例有明确异物吸入史(35.3%)。结论无痛性纤维支气管镜术在儿童难治性肺部疾病的诊断和治疗中发挥重要作用,值得临床推广。Objectives To investigate the application of non-pain flexible fiberoptic bronchoscopy in diagnosis and treatment of children with refractory pulmonary disorders. Methods Clinical data from 221 pediatric patients with 241 cases of flexible bronchoscopy were retrospectively analyzed. All patients were using intravenous propofol anaesthesia. Results In 75 patients with persistent or recurrent wheezing, malacoma and stenosis were found in 30 patients （40.0%）, followed by inflammation in 26 patients （34.7%）, airway anomaly in 9 patients （12.0%）. In 72 patients with atelectasis, inflammation was found in 49 patients （68.1%）, followed by airway abnormalities （31.9%）. After bronchoalveolar lavage and administration of drugs, 83.8% patients with atelectasis were cured in one month and 92.7% in three months. In 17 patients with airway foreign body, foreign body was removed in 11 patients by bronchofibroscope, only 6 patients （35.3%） had a clear history of foreign body aspiration. Conclusions Non-pain flexible fiberoptic bronchoscopy plays an important role in diagnosis and treatment of children with refractory pulmonary disorders. It is worth to be widely implemented.

关 键 词：纤维支气管镜检术 难治性肺部疾病 儿童 

分 类 号：R725.6[医药卫生—儿科]