80例新生儿行纤维支气管镜检查的临床特征及支气管肺泡灌洗液病原学检查结果

Clinical Features of fiberoptic Bronchoscopy and etiological Results of the bronchoalveolar Lavage Fluid in 80 Neonates

目的探讨对新生儿行纤维支气管镜检查的临床研究及支气管肺泡灌洗液病原学研究。方法于2018年01月至2020年12月间抽选在郑州儿童医院新生儿重症监护病区行纤维支气管镜检查的80例新生儿作为研究组,同期选择40例非新生儿作为对照组,对比两组的临床特征、支纤镜检查结果和支气管肺泡灌洗液病原学检查结果。结果两组胃肠道症状、发热、喂养困难、喘息、声嘶、肺不张、合并脏器损伤占比的比较,差异无统计学意义(P>0.05);研究组中,先天性心脏病、呼吸困难、青紫的占比高于对照组,差异有统计学意义(P<0.05);而肺部湿啰音、呛咳、咳嗽的占比低于对照组,差异有统计学意义(P<0.05)。两组的喉软化、气管和支气管狭窄、气管和支气管软化、先天性肺发育不良检出率比较,差异无统计学意义(P>0.05);研究组的支气管炎、呼吸道痰栓堵塞、支气管结构异常检出率低于对照组,差异有统计学意义(P<0.05)。研究组革兰阴性菌、革兰阳性菌感染率高于对照组,差异有统计学意义(P<0.05)。结论新生儿出现呼吸道感染时并无特异性临床表现,而通过纤维支气管镜检查,可及时了解患儿的感染情况,病原学主要为革兰阴性菌、革兰阳性菌感染。

Objective To investigate the clinical characteristics of fiberoptic bronchoscopy and the etiological results of bronchoalveolar lavage fluid in 80 neonates.Methods A total of 80 neonates who underwent fiberoptic bronchoscopy in neonatal intensive care unit of Zhengzhou Children’s Hospital from January 2018 to December 2020 were selected as the study group,and 40 non-neonates were selected as the comparison group during the same period.The clinical features,bronchofibroscopy result and etiological results of bronchoalveolar lavage fluid of the two groups were compared.Results There was no significant difference in the proportion of gastrointestinal symptoms,fever,feeding difficulties,wheezing,hoarseness,atelectasis,and combined organ damage between the two groups(P>0.05).The proportion of congenital heart defect,dyspnea and cyanosis in the study group was higher than that in the comparison group(P<0.05),the proportion of lung wet rales,choking cough and cough was lower than that of the comparison group,and the difference was statistically significant(P<0.05).There was no significant difference in the detection rates of laryngomalacia,tracheal and bronchial stenosis,tracheal and bronchomalacia,and congenital pulmonary dysplasia between the two groups(P>0.05).The abnormal detection rate of bronchitis,respiratory tract phlegm blockage and abnormal bronchial structure in the study group was lower than that in the comparison group,and the difference was statistically significant(P<0.05).The infection rate of gram-negative bacteria and gram-positive bacteria in the study group was higher than that in the comparison group(P<0.05).Conclusion There are no specific clinical manifestations in neonates with respiratory tract infection,but the infection status of infants can be timely understood through fiberoptic bronchoscopy,the etiology is mainly gram-negative bacteria and gram-positive bacteria.