摘要
目的:探讨小儿肺不张的病因构成和支气管镜的临床应用价值。方法:回顾性分析我院143例儿童肺不张的临床表现、影像学检查结果、支气管镜检查等资料,分析病因构成和支气管镜的诊断和治疗价值。结果:①支气管镜检查93例(占65.0%),确诊为支气管异物29例,管外压迫9例,气道先天畸形8例(支气管狭窄4例、软化2例,气管性支气管2例),支气管结核3例,支气管肿瘤1例,其余43例均表现支气管炎症性改变。②病因构成占前三位的分别是炎症性肺不张(占52.4%)、支气管异物(占20.3%)和肺结核(占7.7%)。肺不张最常见的部位分别为右中叶(占25.9%)、左上叶(占19.9%)和右上叶(占16.3%)。③75例炎症性肺不张中,43例经支气管镜下行局部肺段冲洗,入院2周复查X线胸片完全恢复33例(占76.7%)、好转10例(占23.3%),未行支气管镜的32例患儿中,入院2周复查X线胸片完全恢复16例(占50.0%)、好转11例(占34.4%)、无效5例(占15.6%),两组相比差异有统计学意义(P<0.01)。结论:肺不张患儿占前三位的病因分别是炎症性肺不张、支气管异物和肺结核,年龄及部位对判断病因有一定帮助。支气管镜对小儿肺不张的诊断及治疗具有很大的优势。
Objective： To investigate the causes of pediatric atelectasis and the clinical implications of bronchoscopy in the treatment of pediatric atelectasis. Methods： The clinical data （including clinical manifestations, imaging findings, bronchoscopic findings and so on.） obtained from 143 cases of pediatric patients with atelectasis admitted in our hospital were analyzed retrospectively; so as to draft the etiological causes of the disease, as well as the the diagnostic and therapeutic implications of bronchoscopy. Results： ① The pediatric patients （94 boys and 49 girls） aged between 1 month and 13 years, with an average age of 19 months and a median age of 17 months. Of these patients, 60 aged 〈 1 years; 34 aged between 1 and 3 years; 30 aged between 3 and 7 years and 19 aged 〉 7year. ②93 of the patients （65.0%） have underwent bronchoscopic scans, at which 29 patients were diagnosed with presence of bronchial foreign body, 9 with bronchial external oppression, 8 with congenital malformations of respiratory tracts （4 cases of bronchial stenosis and 2 cases of bronchomalacia）, 2 with tracheal bronchus, 3 with bronchial tuberculosis, 1 with bronchial tumor and the rest of 43 were diagnosed with bronchial inflammatory changes. ③ In etiological analysis, the 3 most prominent pathogenic factors were inflammatory atelectasis （52.4%）, presence of bronchial foreign body （20.3%） and tuberculosis （7.7%）. The most common areas of atelectasis included the right middle lobe （25.9%）, the left upper lobe （19.9%） and the right upper lobe （16.3%）. ④Among the 75 patients with inflammatory atelectasis, 43 of them were treated with bronchoscopic segmental lung washing; and 33/43 （76.7%） patients demonstrated complete recovery at Chest X-ray review conducted 2 week after admission, while 10/43 patients （23.3%） showed a certain degree of improvement. Among the 32 pediatric patients who did not undergo bronchoscopic examination, only 16/32 patients （50.0%） showed complete
出处
《温州医学院学报》
CAS
2013年第5期332-335,共4页
Journal of Wenzhou Medical College
关键词
肺不张
病因构成
治疗
支气管镜
儿童
atelectasis
etiological causes
treatment
bronchoscopy
children
