摘要
目的探讨儿童局限性肺不张的病因诊断及纤维支气管镜(纤支镜)镜下治疗对病变部位复张的治疗效果。方法经肺部影像学证实为局限性肺不张的226例住院病人,分为纤支镜诊治组(189例)和对照组(37例)。对纤支镜诊治组患儿临床资料及纤支镜检查结果予以分析,并与对照组病例资料进行比较分析。结果纤支镜诊治组189例患儿共行222例次纤支镜诊治术,结果显示全部病例均有支气管粘膜炎性病变,73例病变部位粘液痰栓形成,21例患儿不同程度气管或支气管软化,11例支气管开口异常或管腔狭窄,9例气管支气管异物,3例支气管内新生肉芽形成,2例气管源性支气管,1例气管前壁血管瘤。出院时纤支镜诊治组患儿肺部局限性病变完全复张、部分复张、无明显改善例数分别为146例、27例和7例,而对照组分别为17例、14例、6例,两组比较差异有统计学意义(P<0.05)。纤支镜诊治组平均住院日(12.1±0.2)d,较对照组平均住院时间(16.2±0.4)d短,且差异具有统计学意义(P<0.05)。纤支镜诊治组未出现呼吸心跳骤停或血流动力学改变等不良事件。结论纤支镜术能够明确肺不张病因,促进病变部位复张,缩短平均住院时间,经济且安全性好。
Objective To explore the value of flexible fiberoptic bronchoscopy in the diagnosis and treatment of pulmonary atelectasis in children. Methods A total of 226 hospitalized children with localized atelectasis confirmed by X-ray or pulmonary CT were divided into bronchoscopy group （ n = 189 ） and control group （ n = 37 ）. The results of fiberoptic bronchoseopy group were compared with control group. Results In bronehoscopy group （ 189 patients）, flexible fiberoptic bronchoscopy was performed 222 times. Bronchial mucosal inflammatory changes were found in all the 189 cases, mucous sputum formation in 73 cases, tra- cheal or bronchial softening in 21 cases, bronchial stenosis or abnormal opening in 11 cases, traeheobronehial foreign body in 9 cases, bronchial neoplasia in 3 cases, tracheal bronchus in 2 cases, and anterior tracheal hemangioma in 1 case . During their stay in hospital, all the eases underwent lavages in the bronchoscopy group, which showed that the lesion had completely expand- ed in 146 cases, partially expanded in 27 cases, and remained unchanged in 7 cases, compared with 17 cases, 14 cases and 6 ca- ses respectively in control group. There was significant difference between the two groups. The average length of hospital stay was （12.1±0.2） days in bronchoscopy group and（16.2±0.4） days in control group, respectively. There was significant difference between the two groups. There was not any respiratory arrest or hemodynamic changes in bronchoscopy groups. Conclusion Fi- brobronchoseopy can help identify the cause of atelectasis, promote the reexpansion of the lesion, shorten the average length of hospital stay, and ensure safety.
出处
《解放军预防医学杂志》
CAS
2016年第6期899-901,共3页
Journal of Preventive Medicine of Chinese People's Liberation Army
基金
国家自然基金面上项目(No.81472018)
关键词
儿童
肺不张
纤维支气管镜
Children
atelectasis
flexible fiberoptic bronchoscopy
