纤维支气管镜检查在儿童慢性咳嗽中的诊断价值

Etiologic identification of chronic cough by bronchofibroscopy in children

目的探讨和分析纤维支气管镜检查在诊断小儿慢性咳嗽中的应用价值。方法2006年1月至2007年3月,对原因不明或常规治疗效果不佳的反复或持续性咳嗽时间超过1个月的慢性咳嗽患儿118例,男73例,女45例,年龄3个月至13岁,应用纤维支气管镜,在局部麻醉下进行病因检查和局部治疗。结果118例患儿中有115例获病因诊断,最多见的原因依次为反复感染(39例)、支气管异物(19例,其中18例成功取出)、上呼吸道咳嗽综合征(17例)、支气管哮喘或咳嗽变异性哮喘(17例),其他较少见的有喉-气管-支气管软化、先天畸形、纤毛不动综合征等。结论儿科开展纤维支气管镜术对儿童慢性咳嗽的病因诊断具有重要价值,是一种安全有效的检查方法。

Objective To study the value of bronehofibroseopy in the etiologic identification of chronic cough in children. Methods Under local anesthesia of lidocaine, bronchofibroscopy was performed in 118 children with chronic cough of unknown origin （73 males and 45 females）. Their ages ranged from 3 months to 13 years. Results The cause of chronic cough was identified in 115 cases. The most common cause was respiratory infection （n = 39）, followed by bronchial foreign bodies （n = 19 ）, upper airway cough syndrome （n = 17 ）, bronchial asthma or cough variant asthma （ n = 17 ）, bronchomalacia （ n = 7 ）, bronchial congenital malformation （ n = 5 ）, primary ciliary dyskinesia （ n = 3 ）, gastro-esophageal reflux （ n = 3 ）, bronchial tumor （ n = 2 ）, bronchial tuberculosis （ n = 1 ）, pulmonary fibrosis （ n = 1 ） and idiopathic pulmonary hemosiderosis （ n = 1 ）. Conclusions Bronchofibroscopy is useful in the etiologic identification of chronic cough in children.