儿童气管支气管软化症合并肺部感染的临床特征及电子纤维支气管镜的诊治意义

Clinical characteristics of tracheobronchomalacia complicated with pulmonary infection in children and the significance of electronic fiberoptic bronchoscopy in diagnosis and treatment

目的 分析儿童气管支气管软化症(TBM)合并肺部感染的临床特征,探讨电子纤维支气管镜在该类疾病中的诊断及治疗意义。方法 收集因反复肺部感染住院的236例患儿资料,其中经电子纤维支气管镜确诊TBM37例,分析儿童TBM的临床特征及电子支气管镜检查结果,比较TBM患儿与非TBM患儿的差异。结果 TBM患儿1岁内者占比高(30/37)。TBM患儿年龄小于非TBM患儿,住院时间长于非TBM患儿(P均<0.05)。TBM患儿与非TBM患儿均主要表现为咳嗽、喘息及反复呼吸道感染,男女性别比例比较差异无统计学意义(P均> 0.05)。TBM患儿镜下以轻、中度及1个部位软化为主,转归良好。结论 TBM是低龄儿童反复肺部感染、喘息的重要因素之一,TBM症状难以识别,支气管镜检查有利于及时诊治。

Objective To analyze the clinical features of children with tracheobronchomalacia(TBM)complicated with pulmonary infection,and to explore the significance offiberoptic bronchoscopy in the diagnosis and treatment of this disease.Methods Clinical data of 236 children admitted to our hospital due to recurrent pulmonary infection were collected.Among them,37 children were diagnosed with TBM byfiberoptic bronchoscopy.Clinical features of TBM andfiberoptic bronchoscopy results were analyzed.The differences between TBM and non-TBM children were statistically compared.Results The proportion of TBM children aged<1 year was high(30/37).The average age of TBM children was significantly younger than that of non-TBM counterparts,and the average length of hospital stay of TBM children was significantly longer than that of non-TBM counterparts,and the differences were statistically significant(both P<0.05).The main manifestations of TBM and non-TBM children were cough,wheezing and recurrent respiratory tract infection,and there were no statistical differences in the male-to-female ratio(all P>0.05).Fiberoptic bronchoscopy found mild and moderate TBM at a single site in TBM children,and favorable outcomes were obtained.Conclusion TBM is one of the important factors of recurrent pulmonary infection and wheezing in young children.It is challenging to identify the symptoms of TBM.Bronchoscopy is beneficial to timely diagnosis and treatment.