小儿肺不张病例中塑型性支气管炎的诊断治疗(附5例报告)

The diagnosis and treatment of plastic bronchitis in children with pulmonary atelectasis

目的研究总结小儿肺不张病人中塑型性支气管炎的发病特点,探讨其诊断和治疗方法。方法 2010-01～2010-05首都医科大学附属北京儿童医院PICU病房共收治16例肺不张病人,回顾性分析其发病病因、临床特点、病原学、治疗过程及治疗效果。结果 16例中行纤维支气管镜检查8例,5例支气管镜检取出异物,诊断为塑型性支气管炎,这5例病人经纤维支气管镜灌洗、呼吸支持、呼吸道管理及抗感染治疗,均痊愈出院。结论肺不张病人要高度警觉塑型性支气管炎的发生,积极进行纤维支气管镜检查和治疗,塑型性支气管炎是儿科危重症之一,确诊需依靠支气管镜检查和病理组织学检查。纤维支气管镜灌洗去除支气管内异物是唯一有效的治疗方法。

Objective To investigate the clinical characteristics,diagnosis and therapeutic approaches of plastic bronchitis in children with pulmonary atelectasis.Methods The clinical profiles of 16 children with pulmonary atelectasis admitted to Beijing Children＇s Hospital from January 2010 to May 2010 were retrospectively analyzed.Results Of 16 patients with pulmonary atelectasis,eight received bronchoscope inspection,and five were confirmed as plastic bronchitis and cured after respiratory lavage by bronchial endoscopy,mechanical ventilation,airway management and anti-infection treatment.Conclusion The occurrence of plastic bronchitis in patients with pulmonary atelectasis should be alerted.Bronchial endoscopy should be carried out actively in pulmonary atelectasis patients.Plastic bronchitis is one of the pediatric critical diseases,and its diagnosis depends on bronchial endoscopy and histopathology.The only effective method is the bronchial endoscopy.