儿童气管性支气管79例临床分析

Clinical Analysis of Tracheal Bronchus in 79 Children

目的:探讨儿童气管性支气管的临床特征,提高对儿童气管性支气管的认识及诊疗水平。方法:回顾性分析79例经支气管镜检查确诊气管性支气管患儿的临床资料。结果:先天性气管性支气管患儿79例,移位型59例,额外型20例,均为右侧壁。79例中合并1种呼吸道发育异常31例,2种呼吸道发育异常11例,以反复或持续咳嗽、喘息、局限性肺炎、肺气肿等为主要临床症状。经过抗感染、对症及支气管肺泡灌洗(BAL)等综合治疗后大部分患儿病情缓解。结论:气管性支气管异常在临床上并不少见,以移位型及右侧壁居多,大部分因肺炎住院,常合并其他呼吸系统疾病及先天性心脏病。临床上对于反复或者持续咳嗽、喘息、局限性肺炎及肺气肿等治疗效果不佳时,需考虑气管性支气管,可行支气管镜协助诊断及治疗。

Objective:To investigate the clinical features of children with tracheal bronchus(TB)and to improve the understanding and diagnosis of TB in children.Methods:The clinical data of 79 children with TB confirmed by bronchoscopy were retrospectively analyzed.Results:Totally 79 patients were identified as having tracheal bronchus,among whom 59 patients were shift type,20 patients extra type and all located at the right tracheal wall.Besides,31 cases were found accompanied with one type of tracheo bronchial anomalies,and the other 11 patients had 2 types of anomalies.Recurrent or persistent cough,wheezing,localized pneumonia and hyperinflation were the most common symptoms in the patients with TB.The symptoms in most of the patients were relieved through anti-inflammatory,bronchoalveolar lavage(BAL)and other comprehensive treatment.Conclusion:TB is not unusual in pediatric patients,with extra type and the right wall of the trachea mainly.Most of them need treatment for pneumonia,often combined with other respiratory diseases and congenital heart disease.TB should be considered when the treatment of recurrent or persistent cough,wheezing,refractory pneumonia,or hyperinflation is not effective.Bronchoscopy can be used to assist diagnosis and treatment.