570例可弯曲支气管镜术患儿临床诊治分析

Clinical diagnosis and treatment of 570 children underwent flexible bronchoscopy

目的通过分析570例行可弯曲支气管镜(FB)术儿童的临床资料,探讨FB在儿童呼吸道疾病诊断及治疗中的价值。方法回顾性分析2016年1月-2020年12月在该院儿科行FB检查及介入治疗术的570例患儿的临床资料。结果570例患儿中,术后综合诊断的疾病构成为:气管支气管内膜炎433例(75.96%),气管支气管异物42例(7.37%),喉软骨软化41例(7.19%),塑型支气管炎18例(3.16%),气管/支气管软化7例(1.23%),声带麻痹6例(1.05%),先天性气管食管瘘3例(0.53%),声门下狭窄3例(0.53%),气管狭窄3例(0.53%),舌根囊肿3例(0.53%),声门下血管瘤2例(0.35%),原发性纤毛运动不良症2例(0.35%),烟曲霉菌性肺炎2例(0.35%),会厌囊肿1例(0.18%),声门囊肿1例(0.18%),喉蹼1例(0.18%),X连锁慢性肉芽肿病1例(0.18%),后鼻孔闭锁1例(0.18%)。病原体以革兰氏阳性菌为主,肺炎链球菌占比最大。结论FB检查大大提高了儿童疑难和急危重疾病的诊断速度和准确率,减少了误诊、漏诊,结合经FB介入治疗术可微创、高效、安全地治疗上述疾病。因此,FB检查具有重要的临床价值。

Objective To analyze the clinical data of 570 children underwent flexible bronchoscopy(FB)surgery to explore the value of FB surgery in the diagnosis and treatment of children's respiratory diseases.Methods The clinical data of 570 children who underwent FB examination and interventional therapy from January 2016 to December 2020 were retrospectively analyzed.Results Among 570 children,the disease composition in the comprehensive diagnosis after operation was:433 cases(75.96%)of endobronchitis,42 cases(7.37%)of tracheobronchial foreign bodies,41 cases(7.19%)of laryngomalacia,18 cases(3.16%)of plastic bronchitis,7 cases(1.23%)with tracheal/bronchial softening,6 cases(1.05%)with vocal cord paralysis,3 cases(0.53%)with congenital tracheoesophageal fistula,3 cases(0.53%)with subglottic stenosis,3 cases(0.53%)of tracheal stenosis,3 cases(0.53%)of tongue root cyst,2 cases(0.35%)of subglottic hemangioma,2 cases(0.35%)of primary ciliary dyskinesia,2 cases(0.35%)of aspergillus fumigatus pneumonia,1 case(0.18%)of epiglottic cyst,1 case(0.18%)of glottis cyst,1 case(0.18%)of laryngeal web,1 case(0.18%)of X-linked chronic granulomatous disease,1 case(0.18%)of atresia of posteriornaris.The main pathogens are Gram-positive bacteria,with Streptococcus pneumoniae accounting for the largest proportion.Conclusion FB examination greatly improves the diagnosis speed and accuracy rate of children's difficult and critical diseases,reduces misdiagnosis and missed diagnosis,combined with FB interventional therapy,it can treat the above diseases with minimally invasive,efficient and safe treatment,so it has important clinical value.