纤维支气管镜在20kg以下心脏术后患儿肺部并发症治疗中的应用

The application of flexible fiberoptic bronchoscopy in pulmonary complications after cardiac surgery in pediatric patients below 20kg

目的明确纤维支气管镜治疗20kg以下心脏术后患儿肺部并发症的效果。方法将该中心2009年3月～2010年5月同期入院手术治疗的20kg以下心脏患儿随机分为两部分,设置每部分中出现术后肺部并发症的患儿分别FB组(20例)和对照组(20例),给予不同治疗方案。比较两组治疗效果,患儿体温及血常规白细胞计数变化趋势,并发症持续时间、ICU滞留时间,二次或多次气管插管例数。结果 FB组所有患儿均安全顺利完成检查及治疗;所有患儿恢复良好。对照组1例患儿术后第5天因多脏器功能衰竭死亡,余患儿恢复良好。FB组患儿体温及白细胞计数较早恢复正常;与对照组比较,FB组患者并发症持续时间、ICU滞留时间短差异有显著性(P<0.05);FB组二次或多次气管插管较对照组数量少,但差异无显著性。结论纤维支管镜治疗20kg以下心脏术后小儿肺部并发症是安全有效的,并发症治愈时间较短。

【Objective】To identify treatment effect of flexible fiberoptic bronchoscopy in pulmonary complications after cardiac surgery in pediatric patients below 20 kg. 【Methods】Pediatric patients below 20kg were randomly admitted for two parts in our department from Mar 2009 to May 2010. According to treatment methods, pediatric patients with pulmonary complications in both parts were all sampled and grouped as FB group （20 cases） and control group （20 cases） after heart operation. The clinical records from two groups were compared in terms of treatment effect, ICU time, complications lasting time, frequency of rentubation and variation tendency of WBC and temperature.【Result】All pediatric patients in FB group were successfully examined without accident, and had good recoveries. One patient in control group died of multiple organ failure in the fifth day post operation, while the others had a good recovery. Compared with control group, FB group provided an earlier recovery on fever and WBC, and shorter ICU time and complications lasting time （P〈0.05）. The frequency of re-intubation in FB group was lower than that in control group, but had no significantly statistical difference. 【Conclusion】The application of flexiblefiberoptic bronchoscopy in pulmonary complications after cardiac surgery in pediatric patients below 20 kg is safe and effective. Moreover, pulmonary complications are cured in a shorter time.