纤维支气管镜在新生儿呼吸系统疾病诊治中的应用

Application value of fiber bronchoscopy in diagnosis and treatment of neonatal respiratory disorders

目的探讨纤维支气管镜在新生儿呼吸系统疾病诊治中的应用。方法选择2015年4月至2019年4月在安徽省儿童医院行纤支镜检查的50例新生儿作为研究对象,回顾性分析纤支镜检查结果、支气管肺泡灌洗结果以及手术前后相关指标的变化。结果50例患儿中,18例(36.00%)表现为气促的新生儿肺炎和/或肺不张者,22例(44.00%)表现为持续喉喘鸣和/或吸气性呼吸困难者,10例(20.00%)表现为声音嘶哑和/或哭声低弱者。31例患儿进行支气管肺泡灌洗并送检病原学检测,其中,22例为阴性(70.97%),9例为阳性(29.03%)。临床转归结果:痊愈2例(4.00%),好转37例(74.00%),无改善和/或加重11例(22.00%)。50例患儿术前、术中、术后的心率及血氧饱和度进行比较,差异有统计学意义(P<0.05);术后第2天时,C反应蛋白(CRP)水平均较术前下降,差异有统计学意义(P<0.05);术后1 h时,PO 2水平较术前升高,差异有统计学意义(P<0.05)。18例(36.00%)患儿出现低氧血症,2例(4.00%)发生支气管黏膜轻微出血,1例(2.00%)术后出现抽搐。结论纤支镜在新生儿呼吸系统疾病中有较明显的诊治效果,术后预后较好,在该疾病的诊治中具有重要的应用价值。

Objective To investigate the application value of fiberoptic bronchoscopy in thediagnosis and treatment of neonatal respiratory diseases.Methods A total of 50 cases who undertook fiberoptic bronchoscopy in our hospital from April 2015 to April 2019 were enrolled in the study.The results of examinations,bronchoalveolar lavage fluid biopsies and perioperative items were evaluated via retrospective analysis.Results A total of 18 of 50 cases(36.00%)manifested polypnea were diagnosed with pneumonia and/or pulmonary atelectasis,22 cases(44.00%)manifested continuous laryngeal stridor and/or inspiratory dyspnea,and 10 cases(20.00%)showed hoarseness and/or crying weakness.A total of 31 of 50 cases underwent bronchoalveolar lavage biopsy and pathogenic microbiological biopsy,among which 22 cases showed negative result(70.97%),compared with 9 cases with positive result(29.03%).The clinical outcome revealed that 2 cases were cured(4.00%),37 cases were in improved condition(74.00%),and 11 cases were in maintained and/or advanced conditions(22.00%).There was statistical significance in heart rate(HR)and SpO 2 among pre-,intra-and post-examination of 50 cases(P<0.05).The CRP level of post-examination day 2 decreased statistically compared with that of pre-examination(P<0.05).PO 2 level of post-examination 1 hour was statistically higher than that ofpre-examination(P<0.05).A total of 18 out of 50 cases manifested hypoxemia(36.00%),2 cases manifested slight exudative bleeding on bronchial mucosa(4.00%),and 1 case had convulsion after examination(2.00%).Conclusion Fiberoptic bronchoscopy is feasible,safe and effective inthe treatment of neonatal respiratory diseases.The post-examinational prognosis is favorable.It has a vital clinical value in the diagnosis and treatment of neonatal respiratory diseases.