反复肺部感染、脱机困难与气道发育异常

Recurrent pulmonary infection, offiine difficulties and airway abnormalities

目的 探讨反复肺部感染、脱机困难与气道发育异常的关系与异常类型.方法 对2008年2月至2010年5月入住我院PICU行电子支气管镜检查的43例重症肺炎患儿的临床资料进行回顾性分析.结果 43例患儿中有24例存在不同程度的气道发育异常,异常类型以气道软骨软化最多,共15例;气管狭窄5例;喉部发育异常3例;右支气管与右肺缺如1例.结论 对临床表现有生后不久反复喘息、呼吸道重症感染治疗效果不好或临床脱机困难、经有效吸痰吸氧治疗PCO2居高不降、阵发性青紫又排除心脏疾患的患儿,存在气道发育异常的可能性较大,应尽早行电子支气管镜检查,以明确诊断.

Objective To discuss the relationship between pulmonary infection, offline difficulties and airway abnormalities and to discuss the type of airway abnormalities. Methods The clinical data of 43 patients of severe pneumonia with inspection of electronic fibro-bronchoscope in PICU from Feb 2008 to May 2010 were retrospectively analyzed. Results In the 43 cases,24 cases existel different degrees of airway abnormalities, most of airway cartilage softening,in 15 cases; laryngeal dysplasia in 3 cases; absence of the right bronchus and right lung in 1 case. Conclusion Many children may exist airway abnormalities,if they have such performance as the clinical manifestations of recurrent wheezing after birth, refractory respiratory infection or difficulties in clinical offline, the increase of PCO2 though the effective suction, paroxysmal cyanosis and excluded with heart disease. Those children should undergo inspection with electronic fibro-bronchoscope to confirm the diagnosis as early as possible.