硬性气管镜联合纤维支气管镜肺泡灌洗在儿童内源性异物中的治疗价值

The value of rigid bronchoscopy combined with fiberoptic bronchoscopic alveolar lavage in the treatment of endogenous foreign bodies in children

目的探讨硬性气管镜联合纤维支气管镜肺泡灌洗在儿童内源性异物中的治疗价值。方法选取2018年3月至2020年6月江西省儿童医院收治的72例内源性异物患儿作为研究对象,根据具体治疗方案的不同分为观察组与对照组,每组36例。观察组给予硬性气管镜联合纤维支气管镜肺泡灌洗,对照组采用硬性气管镜去除异物,比较两组术后气管通畅率、肺炎和肺气肿好转或痊愈率、术后治疗情况、术后3个月病情反复情况。结果术后1周,观察组术后气管通畅率、肺炎和肺气肿好转或痊愈率均高于对照组,差异有统计学意义(P<0.05)。观察组术后抗生素使用时间、继续住院时间、肺部听诊啰音消失时间、症状(咳嗽、咳痰)消失时间均短于对照组,差异有统计学意义(P<0.05)。术后3个月内,观察组再出现症状、再次出现气管堵塞、再次手术行单纯灌洗发生率均低于对照组,差异有统计学意义(P<0.05)。结论硬性气管镜联合纤维支气管镜肺泡灌洗治疗内源性异物的效果显著,能有效清除患者内源性异物,快速康复炎症,预防炎症反复。

Objective To explore the value of rigid bronchoscopy combined with fiberoptic bronchoscopic alveolar lavage in the treatment of en-dogenous foreign bodies in children.Methods 72 children with endogenous foreign bodies admitted to Jiangxi Children's Hospital from March 2018 to June 2020 were selected as the research subjects,and they were divided into the observation group and the control group according to the spe-cific treatment plan,with 36 cases in each group.The observation group was given rigid bronchoscopy combined with fiberoptic bronchoscopy alveo-lar lavage,while the control group was given rigid bronchoscopy to remove foreign bodies,the postoperative patency rate of trachea,improvement or recovery rate of pneumonia and emphysema,postoperative treatment and disease recurrence 3 months after operation were compared between the two groups.Results 1 week after operation,the postoperative patency rate of trachea,the improvement or recovery rate of pneumonia and emphyse-ma in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Postoperative an-tibiotic use time,hospital stay time,disappearance time of auscultation rales(cough and expectoration symptoms)in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).Within 3 months after operation,the probability of reoccurrence of symptoms,reoccurrence of trachea blockage,reoperation for simple lavage in the observation group was lower than those in the con-trol group,and the differences were statistically significant(P<0.05).Conclusion The rigid bronchoscopy combined with fiberoptic bronchoscopy alveolar lavage is effective in the treatment of endogenous foreign bodies,which can effectively remove endogenous foreign bodies,rapidly recover from inflammation and prevent recurrence of inflammation.