纤维支气管镜在儿童慢性咳嗽的临床应用分析

Clinical Application Analysis of Fiberoptic Bronchoscope in Children with Chronic Cough

目的分析纤维支气管镜在儿童慢性咳嗽临床诊治中的应用价值。方法方便选取2016年8月—2017年8月在该院呼吸科进行治疗的100例慢性咳嗽患儿,均使用纤维支气管镜进行检查,观察患儿气管、支气管的病变情况,根据需要采集不同的标本做进一步的检查,并进行局部灌洗、取出异物等。结果气管-支气管内膜炎40例(40%),支气管异物18例(18%),先天性心肺发育畸形8例(8%),上气道咳嗽综合征17例(17%),支气管内膜结核12例(12%),正常5例(5%);刷检涂片检查发现存在革兰阳性菌以及革兰阴性菌的患儿共19例(19/50,39%);肺泡灌洗液培养,阳性结果共8例(8/56,14.3%)。16例患儿通过纤支镜的支气管异物成功取出,咳嗽得到有效缓解。纤支镜术不良反应发生率为18%,且均为轻微并发症。结论纤支镜儿童慢性咳嗽的诊断和治疗中具有重要价值,值得在临床上推广和使用。

Objective To analyze the application value of fiberoptic bronchoscopy in the diagnosis and treatment of chronic cough in children. Methods A total of 100 children with chronic cough who were convenient treated in the Department of Respiratory Medicine in the hospital from August 2016 to August 2017 were selected for fiberoptic bronchoscopy. The pathological changes of the trachea and bronchi were observed. Specimens were further examined and local lavage and removal of foreign bodies were performed. Results 40 cases of tracheo-endocarditis（40%）, 18 cases of bronchial foreign bodies（18%）, 8 cases of congenital heart and lung development malformations（8%）, 17 cases of upper airway cough syndrome（17%）, bronchial endomyocardial tuberculosis in 12 cases（12%）, normal in 5 cases（5%）; brush smear examination found the presence of gram-positive bacteria and gram-negative bacteria in children 19 cases（19/50 cases, 39%）; Alveolar lavage fluid cultures were positive in 8 cases（8/56 cases, 14.3%）. 16 children were successfully removed by bronchial foreign bodies under bronchoscopy, and cough was effectively relieved. The incidence of adverse reactions of bronchoscopy was 18%,and all were minor complications. Conclusion Bronchobronchoscopy has important value in the diagnosis and treatment of chronic cough in children. It is worthy of promotion and use in clinical practice.