纤维支气管镜在儿童气管支气管异物中的诊疗价值

Value of Fiberoptic Bronchoscopy in Diagnosis and Treatment of Tracheobronchial Foreign Body in Children

目的:探讨纤维支气管镜(简称纤支镜)在儿童气管支气管异物中的诊疗作用。方法:对我院2016年1月-2018年12月期间住院的25例行纤支镜操作的气管-支气管异物的临床病例进行回顾性分析。结果:镜下明确诊断气管-支气管异物25例,男19例,女6例(3.17:1);年龄11月龄~6.5岁,<3岁21例(84.0%)例;气管镜操作前胸部CT明确异物13例(52.0%);食源性异物20例(80.0%),坚果类异物18例(72%);CT提示合并肺炎、肺气肿、肺不张共15例(60.0%),一次性成功取异物23例,成功率92%,异物停留时间越长,取出越困难,镜下炎症改变越重,所有病例均行肺泡灌洗液培养未见异常。结论:纤支镜是诊断儿童气管支气管异物的金标准,具有较好的治疗作用。

Objective:to investigate the clinical effect of fiberoptic bronchoscope(referred to as bronchoscope)in the diagnosis and treatment of tracheobronchial foreign body in children.Methods:a retrospective analysis was conducted on 25 clinical cases of tracheobronchial foreign bodies operated by bronchoscopy in our hospital from January 2016 to December 2018.Results:25 cases were diagnosed with tracheobronchial foreign body under bronchoscopy,19 cases were male and 6 cases were female(3.17.1),age from 11 months old to 6.5 years old,21 cases were less than 3 years old(84.0%),13 cases were diagnosed by chest CT before bronchoscopy(52.0%).20 cases were Foodborne foreign body(80.0%),18 cases were nuts(72%),15 cases were CT prompted merge pneumonia,emphysema,atelectasis,one-time success treatment in 23 cases,the success rate of 92%,the longer the foreign body retention in airway,the more difficult to take out,the heavier inflammatory change of microscopical.all cases were performed alveolar lavage culture and did not see abnormalities.Conclusion:fiberoptic bronchoscopy is the gold standard for the diagnosis of tracheobronchial foreign body in chiildren and has obvious therapeutic effect.