支气管镜检查术用于反复咳喘疾病的诊治作用分析

The application of bronchoscopy to the diagnosis and therapy of diseases with repeatedly coughing and wheezing

目的探讨支气管镜检查术在反复咳喘疾病诊治中的作用。方法对首都儿科研究所2005年9月至2008年3月诊治的244例反复咳嗽、喘息,病程在1个月以上患儿行支气管镜检查及治疗的临床资料进行综合分析。结果149例"咳喘原因待查"患儿支气管镜检查镜下最常见病因为感染,其中支气管炎88例,支气管开口水肿、炎性狭窄6例,痰液阻塞6例;镜检第二位病因为先天气道畸型(22例),占14.8%;镜检第三位病因为气道异物(21例),占14.1%。46例肺炎、肺不张患儿支气管镜检查结果提示感染引起的支气管开口阻塞仍然是小儿肺炎、肺不张迁延不愈的主要原因,占87%,通过支气管镜灌洗、钳夹治疗后多数患儿炎症吸收,肺不张消失。49例临床确诊为"儿童哮喘"患儿大多数镜下表现为支气管炎,占85.7%。结论支气管镜检查术可以为临床反复咳喘患儿诊治提供很大帮助。

Objectives To investigate the diagnostic and therapeutic value of bronchoscopy in children with recurrent cough and wheezing. Methods A total of 244 children with recurrent coughing and wheezing for more than one month were chosen for bronchoscopy. The clinical data were analyzed retrospectively. Results Among 149 cases, the most common findings were bronchitis （88 cases）, bronchial aperture dropsy, inflammatory narrowness and sputum blocking （12 cases）, indicating that the leading cause was the infection, followed by congenital tracheobronchial anomalies, which occurred in 22 cases, accounting for 14.8%of all cases; The third cause was the foreign body in the airway（21 cases）, accounting for 14.1%.In 46 cases with pneumonias and atelectasis, blocking in the airway by infection was the primary cause. After syringed and clamped treatment, most cases recovered.In the 49 cases diagnosed as＂children asthma＂, 85.7% were bronchitis. Conclusion The bronchoscopy can be of significant help for diagnosis and therapy of diseases with repeatedly coughing and wheezing.