儿童钡剂误吸病例分析及儿科纤维支气管镜治疗临床效果评估

The Analysis of Barium Sulphate Aspiration in Children and the Evaluation of Pediatric Bronchoscopy in the Treatment

目的探讨儿童钡剂误吸的原因及纤维支气管镜灌洗治疗的效果评估。方法研究对象为2002年2月至2006年10月在北京儿童医院被确诊为钡剂误吸14例患儿,对其进行回顾性分析,并进行追踪随访。结果①儿童钡剂误吸的发生以婴幼儿为主,新生儿期发生最多,其次为小婴儿,学龄儿少见;②吞咽功能不协调,胃、食管反流是造成钡剂误吸的主要原因;③儿童钡剂误吸的临床表现轻重程度与钡剂吸入量、发生误吸后与原发病的相互作用及治疗开始时间有关;④儿科纤维支气管镜灌洗治疗,可以有效洗出误吸钡剂。结论①儿童钡剂误吸的发生与年龄有关;②本组全部钡剂误吸儿童均为医源性;③早期、多次儿科纤维支气管镜灌洗治疗钡剂误吸有确切疗效。

Objective To explore reasons of barium sulphate aspiration in children and to investigate the treatment efficiency of bronchoalveolar lavage with pediatric bronchoscopy. Methods 14 children with aspirated barium who were admitted in Beijing Children Hospital from February 2002 to October 2006 were retrospectively analyzed and all the patients were followed up. Results （1）The children aspirated barium mainly occurred in infants, which has the highest number of neonatal period, followed by small babys, school-age children were rare. （2） The major reasons of the barium aspiration were the incoordination of swallowing function and gastroesophageal reflux. （3）The clinical manifestations of the children with barium aspiration were due to the dose of the barium sulphate how much they had been aspirated, the interaction with the protopathy, and therapy time. （4） Pediatric bronchoscope lavage treatment can effectively wash out barium. Conclusions （1）The children with barium aspiration were agerelated. （2） All the children with barium aspiration were iatrogenic. （3） Early repeatedly pediatric bronchoscopy lavage treatment of aspirated barium had a exact curative.