30例肺部疾病患儿支气管镜检查与肺胞灌洗液检测

Bronchoscopy and Bronchoalveolar Lavage Fluid in 30 Children of Respiratory Dise ases

[目的]探讨支气管镜与肺胞灌洗液在儿科肺部疾病诊断中的作用。[方法]2004年3月至2005年3月,对30例儿童肺部疾病患者,应用支气管镜检查观察病变部位变化,留取肺胞灌洗液进行细胞分类与细菌培养。[结果]经支气管镜检查,30例患儿均有不同程度的气管黏膜充血,病变部位黏膜充血尤其明显,均有炎性水肿所致的管腔狭窄。肺炎支原体感染者23例,其三级以下支气管管壁有灰白色分泌物附着,黏膜有纵行皱褶、管口变形、管腔狭窄。肺炎支原体合并细菌感染者6例,管壁可见脓性分泌物。肺炎支原体合并支气管内膜结核2例,可见有黏膜肉芽肿或较重的气管狭窄,也可见管外压迫表现。儿童哮喘4例,支气管黏膜略苍白。肺胞灌洗液常规细胞分类,30例中,中性粒细胞比值升高者23例,淋巴细胞比值升高者7例,嗜酸性粒细胞比值升高者5例,巨噬细胞比值降低者27例。[结论]支气管镜下观察气管黏膜的改变结合肺胞灌洗液的细胞分类与细菌培养,对儿童肺部疾病的早期诊断有不可替代的作用。

[Objective]To explore the clinical diagnosis in children of Respiratory Diseases. [Methods]We retrospectively summarized the date about pulmonary disease that diagnosis by fiber- bronchoscopy inspect the locality of disease differentiate the cells of obtained alveolar lavage fluid. [Results] A total of 30 children patient underent bronchoscopy examinate. All the cases presented different grade of airway mucosa congestion,especially in the locatity of disease were obvious mucosa congestion, and inflammation and edema duo to a reduction in airway diameter, bacterial infection were seen in 25 patients and purulent secretion in the airwary. Mycoplasmal infection counts for 23 patients, under 3 generations bronchi wall have greyish-white secretions and mucosa goffer,change of airwary shape and small diameter of the bronchi. Mycoplasmal and bacterial infection were 6 cases, there are grayish-white secretion in the airway. Mycoplasmal and endobronchial tuberculosis were 2 cases who had granuloma and severe airway stenosis. Children asthma were 4 case, bronchial mucosa were pale,a total of 30 patents alveolar lavage fluid were obtained to different cells cases,23 cases were neutrophilia. 7 cases were lymphocythemia. 5 cases were eosinophilia. 27 cases were phagocyte decreased. [Conclusion]The change of airway mucosa under bronchoscopy,alveolar lavage fluid cells difference in the doagnosis of etiology, treatmentand,are worthy.