纤维支气管镜检查及肺泡灌洗液培养对儿童反复喘息诊断及治疗的意义

The Clinical Significance of Fiberoptic Bronchoscopy and Bronchoalveolar Lavage Fluid Culture in the Diagnosis and Treatment of Children with Recurrent Wheezing

目的:利用纤维支气管镜对反复喘息患儿进行检查并对肺泡灌洗液进行病原菌培养,以探讨引起反复喘息的病因,指导临床治疗。方法:收集我院2009年10月至2012年10月因反复喘息住院的153例患儿的临床资料,统计分析纤维支气管镜检查及肺泡灌洗液培养的结果。结果:支气管内膜炎性改变102例(66.7%),支气管异物24例(15.7%),支气管软化20例(13.1%),支气管狭窄5例(3.3%),喉部肿瘤1例(0.7%),支气管内膜结核1例(0.7%)。支气管内膜炎性改变的102例患儿肺泡灌洗液检出致病菌72株,其中革兰阴性菌51株(占阳性标本的70.8%),革兰阳性菌19株(26.4%),真菌2株(2.8%)。结论:纤维支气管镜检查及肺泡灌洗液培养对儿童反复喘息的诊断及治疗有重要意义。

Objective： To observe the clinical significance of fiberoptic bronchoscopy and bronchoalveolar lavage fluid culture in the diagnosis and treatment of children with recurrent wheezing. Methods： The clinical data of 153 children, who were hospitalized for recurrent wheezing from October 2009 to October 2012 were collected. Fiberoptic bronchoscopy was taken and bronchoalveolar lavage fluid was retrieved for culture. Results： The results showed 102 cases （66.7%） with endobronchial inflammation, 24 cases （15.7%） with bronchial foreign bodies, 20 cases （13.1%） with bronchomalacia, 5 cases （3.3%） with bronchial stenosis, 1 case （0.7%） with laryngeal tumor, and 1 case （0.7%） with endobronchial tuberculosis, respectively. Bronchoalveolar lavage fluid culture results showed 51 strains of Gram-negative bacteria （70.8% of positive specimens）, 19 strains of Gram-positive bacteria （26.4%） and 2 strains of fungi（2.8% ）. Conclusions： It has important significance of fiberoptic bronchoscopy and bronchoalveolar lavage fluid culture in the diagnosis and treatment of children with recurrent wheezing.