肺泡灌洗术联合肺表面活性物质治疗1例儿童外源性脂质性肺炎并文献复习  

Alveolar Lavage Combined with Pulmonary Surfactant in the Treatment of a Child with Exogenous Lipid Pneumonia and Literature Review

作　　者：韩洁[1] 叶泽慧[1] 杨洋[1] Han Jie;Ye Zehui;Yang Yang(Children’s Hospital of Chongqing Medical University,National Clinical Research Center for Child Health and Disorders,Ministry of Education Key Laboratory of Child Development and Disorders,Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院,国家儿童健康与疾病临床医学研究中心,儿童发育疾病研究教育部重点实验室,儿童代谢与炎症性疾病重庆市重点实验室,重庆400014

出　　处：《儿科药学杂志》2024年第6期41-44,共4页Journal of Pediatric Pharmacy

摘　　要：目的:探讨经支气管镜肺泡灌洗术联合肺表面活性物质治疗1例儿童外源性脂质性肺炎的应用价值。方法:收集我院收治的1例外源性脂质性肺炎患儿的临床诊疗资料,并进行文献分析。结果:患儿意外吸入油性稀释液体后出现咳嗽、气促进行性加重,血氧饱和度降低,血炎症指标增高,胸部计算机断层扫描(CT)见双肺多发性病变,确诊外源性脂质性肺炎后及时予以经支气管镜肺泡灌洗术,并首次联合应用肺表面活性物质经支气管镜注入治疗,同时予以无创正压机械通气、抗感染、糖皮质激素雾化等治疗。治疗后,患儿咳嗽、气促、低氧血症等临床表现及胸部影像学短期内明显好转。结论:儿童外源性脂质性肺炎早期应用经支气管镜肺泡灌洗术联合肺表面活性物质治疗临床疗效好,有较大临床推广价值。Objective:To probe into the application value of bronchoscopic alveolar lavage combined with pulmonary surfactant in the treatment of a child with exogenous lipid pneumonia.Methods:Clinical diagnosis and treatment data of a child with exogenous lipid pneumonia admitted into our hospital were collected,and the relevant literature were retrospectively analyzed.Results:Following accidental aspiration of oily diluent,the child developed cough,progressive aggravation of shortness of breath,decreased blood oxygen saturation,and increased blood inflammation indicators,chest computed tomography(CT)revealed multiple pulmonary lesions bilaterally.After the diagnosis of exogenous lipid pneumonia,the child was given bronchoscopic alveolar lavage in time and combined with pulmonary surfactant for the first time.Meanwhile,non-invasive positive pressure ventilation,antibiotics,and glucocorticoids atomization were given.Clinical manifestations of cough,shortness of breath,hypoxemia and chest imaging were improved significantly in a short period of time.Conclusion:Early application of bronchoscopic alveolar lavage combined with pulmonary surfactant in children with exogenous lipoid pneumonia has significant clinical efficacy and is of great clinical promotion value.

关 键 词：儿童 外源性脂质性肺炎 胸部计算机断层扫描 经支气管镜肺泡灌洗术 肺表面活性物质 

分 类 号：R725.1[医药卫生—儿科]