纤维支气管镜在小儿呼吸道疾病诊治中的应用

Application of fiberbroptic bronchoscopy in the diagnosis and treatment of pediatric respiratory diseases

目的探讨纤维支气管镜(纤支镜)在小儿呼吸道疾病诊治中的价值。方法对2002年2月以来在我院行纤支镜术的196例患儿资料进行回顾性分析。结果196例患儿进行了218次纤支镜诊疗,为195例明确病因。结论纤支镜在小儿呼吸系统疾病的诊疗中能发挥重要作用,且安全可靠,值得在儿科临床推广。

Objective To explore the diagnostic and therapeutic value of fiberbroptic bronehoscopy （FB） in children with respiratory diseases. Methods The clinical data of 196 eases performed by FB since February 2002 in Anhui Provincial Children＇s Hospital were analyzed restrospeetively. Results A total of 218 FB procedures were performed in the 196 eases and confirmed causes for the dis- eases were indicated in 195 cases. Among them, there were 45 ateleetasis eases with inflammatio （n =22; 48.9% ）, followed by foreign body （ n =22,22. 2% ）. Of 47 cases suspected foreign body, 36 cases had confirmation （76. 6% ）. For the patients with chronic cough （ n = 34）, with recurrent or prolonged wheezing （ n = 32） and with refractory pneumonia （ n = 11 ）, acute or chronic endobmnchitis was main causes, followed by foreign body, and other causes which included bronchial stenosis, laryngomalaeia, tracheobmnehomalaeia, trachat tumors, abnormal bronchial branch. The use of FB confirmed the causes of hoarse voice （n = 10）, of dyspnea of unknown origin （n = 10 ）, of hemoptysis （ n = 4） and of low voices （ n = 2）. After the treatment of bronchoalveolar lavage （BAL） and local administration of medication,34 out of 41eases with ateleetasis were improved （ 82. 9% ） and 14 cases of bronchial foreign bodies located under 11 grade bronchus were removed. Its use also achieved optimal effect in the children with recurrent or prolonged wheezing,chronic cough and refractory pneumonia. One case of endotracheal intubation under the guildanee of FB was performed sueeesfully in the department of anesthesiology. Conclusion FB plays an important role in diagnosis and treatment of pediatric respiratory diseases. It is safe and effective. It should be recommended for a wider use in clinical practice of pediatrics.