纤维支气管镜在早产极低体重儿呼吸道疾病诊治中的临床应用

Clinical application of branchofiberoscope in diagnosis and treatment of premature very low birth weight infants with respiratory diseases

目的 评估纤维支气管镜在早产极低体重儿呼吸道疾病诊治中的价值和安全性。方法 选择16例患有呼吸道疾病的早产极低体重儿予以局部麻醉、面罩加压手控供氧下行纤维支气管镜检查和治疗。结果 16例患儿除外1例双肺弥漫出血家属放弃抢救死亡,余15例均治愈出院。9例肺不张患儿经治疗24 h后5例复张,4例未完全复张患儿再次进行第2次支气管镜吸引后于术后48~72 h均复张。无BPD发生。结论 纤维支气管镜检查和治疗对早产极低体重儿呼吸系统疾病能明显缩短肺不张、肺炎等疾病的病程,有助于减少BPD的发生。只要做好充分的术前准备,术中采用局部麻醉和间断面罩手控皮囊供氧的方式,早产新生儿的纤维支气管镜检查和治疗是安全、有效的。

Objective To evaluate the value and safety of branehofiberoseope in diagnosis and treatment of premature very low birth weight infants with respiratory diseases. Methods Sixteen premature very low birth weight infants with respiratory diseases were selected, then branchofiberoscopic examination and treatment were performed under local anaesthesia and positive-pressure ventilation with a face mask. Results Among 16 infants, one infant died of serious pulmonary hemorrhage, the other 15 infants were cured. Among 9 infants with ateleetasis, 5 eases were curd after 24 hours of treatment, the other 4 infants underwent branchofiheroscopic examination and treatment for the second time, then they were cured after 48-72 hours of treatment, no bronchopulmonary dysplasia （BPD） occurred. Conclusion Brancho- fiberoscopic examination and treatment can significantly shorten the course of diseases, such as atelectasis, pneumonia, and reduce the oc- currence of BPD for the premature very low birth weight infants with respiratory diseases. Branchofibemscopic examination and treatment is safe and effective as long as preoperative preparation is sufficient, local anaesthesia and positive-pressure ventilation with a face mask are ap- plied during operation.