支气管镜支气管肺灌洗在儿科的应用

The utilization of bronchoalveolar lavage in children

：观察小儿肺部感染或由此并发的肺不张病例，进行支气管肺灌洗（ＢｒｏｎｃｈｏａｌｖｅｏｌａｒＬａｖａｇｅ，ＢＡＬ）治疗的效果。方法：对８７例此种患儿于金属支气管镜下对病变肺段进行ＢＡＬ（灌洗组），并与３０例常规药物治疗者（对照组）进行治疗后起效时间和疗效的比较。结果：灌洗组起效时间比对照组明显缩短（Ｐ＜０．０１）；两组疗效无显著差异（Ｐ＞０．０５）。结论：支气管镜直视下行ＢＡＬ可及时的清除阻塞物，改善通气功能；同时局部使用抗生素等药物，促进病变的吸收好转，使病程大为缩短。此外，金属支气管镜通气腔大，视野广阔，操作环境宽松，便于清除支气管内阻塞物，较之纤维支气管镜更符合小儿的生理要求，故有较好的使用价值。

Objective:To investigate the clinical effect of bronchoalveolar lavage (BAL) in children with atelectasis owing to pulmonary infection. Method:We compared the preactive period in test group (87 cases) whowere treated by BAI with control group (30 cases) who were treated by conventional drug. Result: The resultshowed a shorter preactive period in test group than that of control group (P <0. 01). No significant difference of effect of treatment was found between this two groups (P >0. 05). Conclusion: Under directly visual metalbronchoscope, we can improve the ventilation function by eliminating the obstructions,and can fasten the absorp-tion and recovery of the foci by using antibiotics locally. So BAL can obviously shorten the course of treatment.Due to the structure defect, using of BAL with fiber bronchoscope is restricted in children. However, metalbronchoscope under total anesthesia can provide a good operation condition which include a large ventilation cavity and a wider visual field, so it has high clinical value in children.