摘要
目的探讨纤维支气管镜检术在小儿呼吸道疾病诊断与治疗中的应用。方法在局部麻醉下,应用Olympus BF3c-40纤维支气管镜对125例病因不明或疗效不佳、反复喘息、慢性咳嗽、肺气肿及肺不张等疾病的患儿进行检查治疗,通过直视下、支气管刷检、活组织检查及肺泡灌洗液的分析,明确病因诊断;应用支气管肺泡灌洗、局部注药进行治疗,并对疗效作出评价。结果小儿疑难呼吸道疾病中,病因主要为感染、异物及结核。小于1岁患儿肺不张主要以痰栓堵塞为主,1～3岁患儿肺不张主要以异物为主,3岁以上以结核、异物为主。发生部位:小于3岁患儿中因炎症痰堵所致的肺不张主要发生在上叶,而3岁以上主要发生在右中叶及左舌叶。因异物所致改为肺不张主要发生于1～3岁患儿,以植物性异物为主,左右支气管发生率相当。痰栓及炎性肿块引起肺不张治疗后复张率明显高于其他原因引起的肺不张,而在异物引起的肺不张中,病程<2个月的复张率明显高于病程>2个月者。结论纤维支气管镜可明确儿科呼吸道疾病的部位、性质及病因,对肺不张的诊断有一定的优势,支气管肺泡灌洗对肺部疾病的疗效,因病因、病史的不同而差异较大,对感染性疾病疗效好,而与病史的长短成反比。纤维支气管镜具有诊断及治疗双重作用,将广泛应用于儿科呼吸道疾病的诊治中。
[Object] To discuss the application of fibrobronchoscopy in the diagnosis and treatment of respiratory diseases of children. [Method] We used the OlympusBF3c-40 fibrobmnchoseopy with the methods of straight inspect, bronchus brush examine, biopsy and analyse of alveolus lavement to examine and therapy the diseases of 125 undefined pathogeny and unsatisfied curative effect cases, including repeated pant and cough, emphysema and atelectasis, to identify the pathogeny and to therapy with alveolus lavement and inject medicine. [Results] The pathogeny of children complex respiratory diseases were infection, external objects and tuberculosis. The cause of atelectasis under the age of 1 year old were mostly sputum jammed, between 1 and 3 years old were external objects, above 3 years old were external objects and tuberculosis. The location of atelectasis was mostly in the upper lung lobe in children under 3 years old and in right-middle lung lobe and left lingual lobe in the children above 3 years old caused by sputum jammed and infection. External objects, especially vegetal objects were appeared in the children between 1 and 3 years old, with the equal frequency of left and right bronchus. The rate of expansion of atelectasis caused by sputum jammed and infection were higher than other reasons, but to the atelectasis caused by external objects, the rate of expansion of history less than 2 months were higher than that above 2 months.[Conclusion] Fiberoptic bronchoscopy can identify the location, and pathogeny of respiratory diseases of children, also has the advantage in the diagnosis of atelectasis. The alveolus lavement has different effect because of different pathogeny and history. It is good for infectious diseases and has the inverse ratio with the history. Fiberoptic bronchoscopy has the double effect of diagnosis and therapy, which can be widely used in the diagnosis and therapy of respiratory diseases of children.
出处
《中国内镜杂志》
CSCD
北大核心
2007年第4期395-398,共4页
China Journal of Endoscopy
关键词
纤维支气管镜检术
呼吸道疾病
儿童
fibrobronchoscopy
disease of respiratory system
children
