纤维支气管镜在小儿肺炎诊治中的临床应用

Clinical application of branchofiberoscope in diagnosis and treatment of children with pneumonia

目的探讨纤维支气管镜（纤支镜）在小儿肺炎诊治中的临床应用价值。方法回顾性分析2011年8月至2013年5月郑州大学第三附属医院呼吸科在局部浸润麻醉下行纤支镜诊治136例小儿肺炎的临床资料。结果136例患儿平均发病年龄为4．5岁，1—6个月42例，6个月～1岁26例，1～3岁36例，3～7岁24例．7～14岁8例。其中肺部感染109例（80．1％），先天性支气管肺发育异常14例（10．2％），支气管异物7例（5．1％）。灌洗液细菌培养阳性37例（27％），痰培养阳性31例（23％），灌洗液培养阳性率略高于痰培养。117例患儿经纤支镜灌洗后症状迅速改善，治愈率为86．0％。7例气管异物经纤支镜做出明确诊断。结论局部浸润麻醉下纤维支气管镜术方法简单，安全有效，为小儿肺炎的病因诊断及治疗提供了安全有效的方法。

Objective To investigate the clinical application value of branchofiberoscope （ bronchoscopy） in the diagnosis and treatment of children with pneumonia. Methods The clinical data of 136 children with pneumonia diagnosed and treated by branchofiberoscope under local infiltration anesthesia in department of respiratory medicine of the third affiliated hospital of Zhengzhou university, from Aug 2011 to May 2013, were retrospectively analyzed. Results The average onset age of 136 children was 4.5 years old, 1 - 6 months in 42 cases, 6 months - 1 years old in 26 cases, 1 - 3 years old in 36 cases, 3-7 years old in 24 cases, 7 -14 years old in 8 cases. Pulmonary infection in 109 cases（80. 1% ）, congenital bronehiallung development abnormalities in 14 patients（ 10. 2% ）, 7 cases （5.1%） of bronchial foreign body. Lavage fluid culture was positive in 37 cases（27% ）. The sputum culture was positive in 31 cases （23 % ） , lavage fluid culture positive rate was higher than that of sputum culture. One hundred and seventeen cases of children with lavage by bronchoscopy after the symptoms improved rapidly, the cure rate was 86%. Seven cases of tracheal foreign bodies were diagnosed by fiberoptic bronchoscopy. Conclusions Branchofiberoscope under local infiltration anesthesia bronchoscopy is simple, safe and effective, providing a safe and effective method for diagnosis and treatment of pediatric pneumonia.