纤维支气管镜在新生儿重症监护病房的诊断、治疗价值

The values of diagnosis and treatment of fiberoptic bronchoscopy in neonatal intensive care unit

回顾性分析在新生儿重症监护病房接受纤维支气管镜检查和治疗的92例患儿的临床特点、镜下诊断结果及疗效。92例患儿中临床表现为呼吸困难(气促、青紫)和一般呼吸道表现(喘鸣、呛咳、鼻塞)最多见,共67例(72.82%),其次是撤机困难的患儿17例(18.48%),其余8例(8.7%)为非典型呼吸道症状(呕吐、声嘶)。镜下诊断主要为呼吸系统解剖学异常,共72例(78.26%),其中最常见的为气管支气管软化、狭窄等,共36例(50%);其次为咽喉部先天性异常32例(44.44%),鼻腔发育异常仅4例。1例气道异物,呼吸道外因素4例均系先天性心脏病致气道受压。76例可见单纯或合并炎症改变(82.61%)。有21例患儿通过纤维支气管镜给予灌洗、异物钳夹等治疗,炎症吸收快,撤机时间缩短,撤机成功率提高。所有患儿检查过程中及检查后未出现严重不良事件。

92 cases in neonatal intensive care unit underwent bronchoscopy were analyzed retrospectively for their clinical features, endoscopic diagnosis and treatment. In 92 cases, the clinical symptoms including dyspnea （ shortness of breath, cyanosis） and general respiratory symptoms （wheezing, cough, nasal congestion） were most common in 67 cases （72. 82% ）, followed by weaning difficulties in 17 cases （18.48%） , remained 8 cases （8.7%） were atypical respiratory symptoms （vomiting, hoarseness）. 72 cases （78.26%） was mainly respiratory system anatomical abnormalities by endoscopic diagnosis. In 72 cases, 36 cases （50%） were the most common for traeheo- bronehomalaeia and stenosis, followed by 32 cases （44.44%） of congenital abnormal throat, and only 4 cases were nasal dysplasia. There were 1 case of airway foreign bodies, 4 cases with respiratory factors of congenital heart disease caused by airway compression, 76 cases （82.61%） with or combined with inflammation, and 21 cases given lavage by fiberoptic bronchoscopy, foreign body forceps treatment, inflammation fast absorption, weaning time, improved the success rate of weaning in 92 cases. All children had no serious adverse events during the examination or later.