纤维支气管镜检查在儿童慢性咳嗽中的诊断价值

The value of bronchoscopy in the diagnosis of chronic cough in children

目的:探讨纤维支气管镜检查在儿童慢性咳嗽中的诊断价值。方法:收治慢性咳嗽患儿40例,均使用纤维支气管镜检查,观察气管、支气管病变情况,并根据需要采集标本做进一步检查,并进行局部灌洗,清洗分泌物、取出异物等操作。结果:支气管哮喘或咳嗽变异性哮喘8例,支气管异物8例,喉-气管-支气管软化2例,上呼吸道咳嗽综合征4例,反复呼吸道感染10例,纤毛不动综合征1例,支气管先天畸形1例,胃-食管反流病1例,肿瘤1例,肺纤维化1例,结核1例,特发性肺含铁血黄素沉积症1例,原因不明1例,灌洗液检出病原微生物14例,病原微生物检出率35.0%,支原体-DNA阳性4例,肺炎衣原体-DNA阳性2例。结论:纤维支气管镜检查对儿童慢性咳嗽病因、病原微生物感染诊断有着重要的临床意义。

Objective:To investigate the value of bronchoscopy in the diagnosis of chronic cough in children.Methods:40cases ofchildren with chronic cough were selected.They were all were examined by bronchoscopy.We observed the changes of trachea andbronchus,and according to the need to collect specimens for further examination,and local irrigation,cleaning secretions,removethe foreign body and other operations were carried out.Results:Bronchial asthma or cough variant asthma in8cases,bronchialforeign body in8cases,2cases of laryngeal tracheal bronchial softening,4cases of upper airway cough syndrome,10cases ofrecurrent respiratory tract infections,1case of cilia fixed syndrome,1case of bronchial congenital malformation,1case ofgastro-esophageal reflux disease,1case of tumor,1case of pulmonary fibrosis,1case of tuberculosis,idiopathic pulmonaryhemosiderosis in1case,1cases of unknown cause,lavage of microbiological detection of14cases,the detection rate of pathogenicmicroorganisms was35%,mycoplasma-DNA positive in4cases,chlamydia pneumoniae-DNA positive in2cases.Conclusion:Fiberoptic bronchoscopy has important clinical significance in the diagnosis of chronic cough cause and pathogenic microbialinfection in children.