可弯曲支气管镜联合硬质支气管镜在小儿气道异物治疗中的应用

Application of Flexible Bronchoscopy Combined with Rigid Bronchoscopy in the Treatment of Airway Foreign Bodies in Children

目的评估可弯曲支气管镜联合硬质支气管镜在小儿气道异物治疗中的有效性和安全性,旨在为临床治疗小儿气道异物提供科学依据。方法选取2021年12月至2024年6月南京医科大学附属淮安第一医院收治的96名气道异物患儿为研究对象。按照随机数字表法分为试验组和对照组,每组48例。试验组采用可弯曲支气管镜联合硬质支气管镜治疗,对照组采用硬质支气管镜治疗。对比两组患儿呼吸功能、炎症反应水平、气道通畅度[采用气道通畅度量表(PAOS)评估]、气道损伤程度[采用气道损伤量表(AIS)评估]及术后并发症发生率。结果试验组术后用力呼气量(FEV1)和用力吸气量(FVC)均高于对照组(P<0.05);试验组术后血清C反应蛋白(CRP)和白细胞计数(WBC)水平均低于对照组(P<0.05);试验组PAOS评分高于对照组,AIS评分低于对照组(P<0.05);试验组术后并发症总发生率(12.50%)低于对照组(29.17%)(P<0.05)。结论可弯曲支气管镜联合硬质支气管镜在治疗小儿气道异物中能显著改善其呼吸功能,降低炎症反应水平和术后并发症发生率,提高气道通畅度,减少气道损伤程度,是一种安全有效的治疗手段。

Objective To evaluate the effectiveness and safety of flexible bronchoscopy combined with rigid bronchoscopy in the treatment of children with airway foreign bodies,aiming to provide scientific basis for clinical treatment of children with airway foreign bodies.Methods A total of 96 children with airway foreign bodies in the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University from December 2021 to June 2024 were included.They were randomly divided into an experimental group(n=48)and a control group(n=48).The experimental group was treated with flexible bronchoscopy combined with rigid bronchoscopy,while the control group was treated with single rigid bronchoscopy.The respiratory function,inflammatory response,airway patency[Pediatric Airway Obstruction Score(PAOS)],airway injury[Airway Injury Scale(AIS)]and incidence of postoperative complications were compared between the two groups.Results The forced expiratory volume in the first second(FEV1)and forced vital capacity(FVC)after surgery in the experimental group were higher than those in the control group(P<0.05).The postoperative serum levels of C-reactive protein(CRP)and white blood cell count(WBC)in the experimental group were lower than those in the control group(P<0.05).The PAOS scores in the experimental group were higher,while the AIS scores were lower compared with those in the control group(P<0.05).The total incidence of postoperative complications in the experimental group was lower than that in the control group(12.50%vs 29.17%,P<0.05).Conclusion Flexible bronchoscopy combined with rigid bronchoscopy can significantly improve respiratory function,reduce inflammatory response,enhance airway patency,reduce airway injury,and lower the incidence of postoperative complications in the treatment of airway foreign bodies in children,which is a safe and effective treatment method.