纤维支气管镜在先天性气道发育异常新生儿应用中的诊断价值

Diagnostic value of fiber bronchoscopy in neonates with congenital airway dysplasia

目的探讨纤维支气管镜在先天性气道发育异常新生儿中的诊断价值。方法 2013年5月至2017年1月湖南省儿童医院新生儿科收治住院的气道发育异常新生儿89例,均经纤维支气管镜检查。结果 89例患儿咽喉部异常包括喉软骨软化65例,会厌囊肿4例,先天性喉蹼3例,声门上血管瘤1例,双侧声带麻痹1例;气管-支气管异常包括气管软化52例;气道狭窄20例,其中单纯性气道狭窄12例,继发性气道狭窄6例,气管性支气管2例;气管食管瘘3例;气管开口处乳头状瘤1例;右侧主支气管缺如1例;左右支气管转位1例。纤维支气管镜最常见的并发症是低氧血症、心率一过性下降,予处理后均能恢复继续操作。结论纤维支气管镜检查在诊断新生儿气道发育中具有重要的作用,技术安全可靠。

Objective To explore the diagnostic value of fiber bronchoscopy in neonates with congenital airway dysplasia.Methods A retrospective study on the results of fiberoptic bronchoscopy was performed in 89 neonates with airway dysplasia.Results A total of 89 neonates were examined by fiberoptic bronchoscopy.Among the cases of throat abnormalities,there were 65 cases of laryngomalacia,4 cases of congenital epiglottis cyst,3 cases of congenital laryngeal web,1 case of hemangioma on the glottis and 1 case of bilateral vocal cord paralysis;those with trachea bronchial abnormalities included 52 cases of tracheomalacia;there were 20 cases of tracheal stenosis,including 12 cases of simple tracheal stenosis,6 cases of secondary tracheal stenosis and 2 cases of tracheal bronchus;there were 3 cases of tracheoesophageal fistula,1 case of tracheal papilloma,1 case of right tracheal absence and 1 case of the left and right bronchi translocation.The most common complications of fiberoptic bronchoscopy were hypoxia and transient decline of heart rate.They all can be returned to normal after treatment.Conclusion Fiber bronchoscopy plays an important role in diagnosis of airway dysplasia in neonates,and it's safe and reliable.