支气管镜术在新生儿呼吸困难伴气道异常中的应用  

Application of Fiberoptic Bronchoscopy for Diagnosis and Treatment of Dyspnea Accompanied by Airway Abnormality in Neonates

作　　者：徐世进 郭佳琦 李丽 XU Shi jin;GUO Jiaqi;LI Li(Ma'anshan People's Hospital,Ma'anshan,Anhui 243000,China;Luoyang Maternal and Child Health Hospital(Henan Second Children's Hospital),Luoyang,Henan 471000,China)

机构地区：[1]安徽省马鞍山市人民医院儿科,安徽马鞍山243000 [2]河南省洛阳市妇幼保健院(河南省第二儿童医院)NICU,河南洛阳471000

出　　处：《转化医学杂志》2024年第4期609-611,615,共4页Translational Medicine Journal

基　　金：洛阳市社会发展领域指导性科技计划项目(2101075A)。

摘　　要：目的探讨支气管镜术在新生儿呼吸困难考虑气道异常时病因及治疗的临床应用意义。方法回顾性选择2020年1月至2023年7月安徽省马鞍山市人民医院收治的不明原因呼吸困难患儿71例为研究对象,对其病例特点、镜检结果及治疗效果等进行总结分析。结果71例不明原因呼吸困难新生儿行支气管镜检查,检查指征前3位分别为撤机失败、支气管肺发育不良(bronchopulmonary dysplasia,BPD)及喉鸣;镜检结果前4位病因为支气管内膜炎23例次(32.1%)、喉软骨软化15例次(21.1%)、气管-支气管软骨软化12例次(16.9%)、气管性支气管7例次(9.9%)。18例无其他呼吸道并发症的支气管内膜炎患儿经支气管灌洗及对症支持治疗治愈,其余根据镜检结果予以对症治疗后症状较前缓解,支气管镜检查术中无严重并发症发生。结论支气管镜术能够安全用于新生儿不明原因呼吸困难的诊断及治疗,当出现撤机失败、支气管肺发育不良及喉鸣时建议行支气管镜探查。Objective To investigate the clinical application significance of fiberoptic bronchoscopy(FB)in identifying causes of neonatal dyspnea.Methods A total of 71 neonates with unexplained dyspnea admitted to the neonatal intensive care unit of Ma'anshan People's Hospital between January 2020 and July 2023 who underwent FB were retrospectively analyzed.Their clinical characteristics,bronchoscopy results,and treatment effects were summarized and analyzed.Results Among the 71 newborns with unexplained dyspnea who underwent bronchoscopy,the top three indications for bronchoscopy were failure of withdrawal from mechanical ventilation,bronchopulmonary dysplasia(BPD),and laryngeal wheezing.The top four diagnoses identified through bronchoscopy were endobronchitis(23 cases,32.1%),laryngeal chondromalacia(15 cases,21.1%),tracheobronchial chondromalacia(12 cases,16.9%),and tracheal bronchus(7 cases,9.9%).Eighteen children with endobronchial inflammation without other respiratory complications were cured by bronchial lavage and symptomatic supportive treatment,while symptoms of the remaining cases were relieved after treatment guided by bronchoscopy findings.No serious complications occurred during bronchoscopy.Conclusion Fiberoptic bronchoscopy can be safely used in the diagnosis and treatment of unexplained dyspnea in neonates.Bronchoscopy is recommended when withdrawal failure,bronchopulmonary dysplasia,or laryngeal wheezing occurs.

关 键 词：呼吸困难 支气管镜 婴儿 新生 

分 类 号：R722.104[医药卫生—儿科]