纤维支气管镜在儿童咯血病因诊断和治疗中的价值  

Value of bronchofibroscopy in etiological diagnosis and treatment of hemoptysis in children

作　　者：郦琳琳[1] 梁慧[1] 王全[1] 赵德育[1] 

机构地区：[1]南京医科大学附属南京儿童医院呼吸科,江苏南京210008

出　　处：《临床儿科杂志》2014年第3期238-241,共4页Journal of Clinical Pediatrics

摘　　要：目的评价纤维支气管镜在儿童咯血病因诊断及治疗中的价值及安全性。方法回顾性分析22例咯血患儿纤维支气管镜检查结果及临床资料。结果引起咯血的主要疾病为支气管、肺部炎症8例(其中伴支气管扩张2例),支气管异物3例,特发性肺含铁血黄素沉着症3例,气道内肿物2例,疑诊肺血管发育异常4例(未行血管造影确诊),原因不明2例。术中并发低氧血症2例。6例患儿镜下有活动性出血,局部予有效止血治疗;3例患儿于右肺下叶取出支气管异物;1例肉芽组织增生导致的肺不张患儿实施病变部位冷冻治疗2次,2周后支气管镜复查阻塞气道的肉芽组织消失,CT检查肺不张消失。结论纤维支气管镜检查是咯血患儿必要且安全的检查方法之一,具有重要的临床诊断和治疗价值。Objective To evaluate the value and safety of flexible bronchoscopy in etiological diagnosis and treatment of hemoptysis in children. Methods The flexible bronchoscopy findings and clinical data of 22 children with hemoptysis were analyzed retrospectively. Results The causes of hemoptysis were as follows, bronchiolitis and pneumonia in 8 cases （2 cases with bronchiectasis）, foreign body in bronchus in 3 cases, idiopathic pulmonary hemosiderosis in 3 cases, neoplasms in airway in 2 cases, suspi-ciion of bronchial pulmonary vessel dysplasia in 4 cases （requiring angiogram） and unknown causes in 2 cases. Two cases suffered hypoxemia. Active bleeding was found in 6 cases and topical hemostasis treatment was effective. The bronchial foreign body was removed from right lower lobe bronchus in 3 cases. One case with atelectasis caused by granulation was treated with bronchoscopic cryotherapy 2 times, no granulation was found during the third bronchoscopy and chest CT showed the atelectasis was cured 2 weeks later. Conclusions Flexible bronchoscopy is one of the necessary and safe examinations in children with hemoptysis and is of important value in clinical diagnosis and treatment.

关 键 词：咯血 纤维支气管镜 冷冻疗法 儿童 

分 类 号：R441.7[医药卫生—诊断学]