摘要
目的探讨硬管支气管镜在儿童塑型性支气管炎诊治中的作用。方法回顾性分析8例塑型性支气管炎患儿的临床特征、硬管支气管镜检查操作要点及术后恢复情况。结果全部病例患侧支气管管腔狭窄，黏膜有弥漫的毛糙、充血、水肿表现，2例黏膜有滤泡样增生，1例取出塑型后黏膜有少许渗血。所有病例均取出内生性异物，呈支气管树状或条索状塑型。塑型堵塞范围情况为右侧主支气管2例，右上叶1例，右侧中间支气管1例，左侧主支气管2例，左下叶1例，右侧主支气管及左侧下叶支气管1例。术后患侧肺呼吸音较术前增强，呼吸困难均缓解，后经进一步治疗后均痊愈出院。内生异物病理检查结果均为I型塑型性支气管炎。结论全麻下经硬管支气管镜取出堵塞呼吸道的塑型性内生异物是诊断及治疗塑型性支气管炎的有效方法，塑型性支气管炎患儿病情危重，进展迅速，应尽早诊断、及时手术，可以大大降低死亡率。
Objective To explore the role of rigid bronchoscope in the diagnosis and treatment of plastic bronchitis. Methods Various clinical parameters, the key points of operation and postoperative recovery were analyzed in 8 patients with plastic bronchitis treated in Department and ICU using retrospective analysis. Results All cases demonstrated bronchial lumen stenosis, mucous membraneare coarse, congestion, edema in the affected side. 2 cases had follicular hyperplasia, 1 case had a few ooze after taking out the plastic type. All cases had endogenous foreign bodies, taking the shape of the bronchial tree or a funicular. Block shape and sites were as follows： right main bronchus 2 cases, superior lobe of right lung 1 case, right middle bronchial 1 case, left main bronchus 2 cases, 1 case with left lower lobe, right main bronchus and left lower lobe bronchus 1 case. The breath sounds of the affected side become more enhanced after operation, with the alliviation of dyspnea. All cases recovered after ICU treatment. The pathologic examination were all type I plastic bronchitis. Conclusions Removement of the endogenous foreign body via rigid bronchoscopy is the effective method in the treatment of plastic bronchitis. Plastic bronchitis is a rapid-developing critical, urgent disease. In order to reduce the mortality, early diagnosis and timely surgery are necessary.
出处
《中华耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2015年第11期944-947,共4页
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
