电子支气管镜在Ⅲ型食管闭锁术后气管食管瘘复发诊断中的应用

Application of electronic bronchoscopy in diagnosis of recurrent tracheoesophageal fistula of type Ⅲ esophageal atresia

摘要:

目的   探讨电子支气管镜在Ⅲ型食管闭锁术后气管食管瘘复发诊断中的应用。方法   回顾分析江西省儿童医院自2010年1月-2014年8月收治的5例Ⅲ型食管闭锁术后怀疑气管食管瘘复发的病例，均采用电子支气管镜结合胃管注入美兰方法进行检查。其中，男4例，女1例，检查年龄为2～15个月，平均7.4个月。结果   5例患儿均在电子支气管镜下见到气管膜部瘘口，胃管内注入美兰后可见美兰自气管膜部瘘口溢出，气管食管瘘复发诊断成立。检查时间为3～7 min，平均为4.2 min。此5例患儿均通过手术证实。结论   使用电子支气管镜结合胃管注入美兰的检查方法，用来诊断食管闭锁术后气管食管瘘复发安全可行，检查时间短，确诊率高。

Abstract:

Objective To investigate the application of electronic bronchoscopy in diagnosis of recurrent tracheoesophageal fistula of type Ⅲ esophageal atresia. Methods 5 patients were reviewed who were suspected postoperative tracheoesophageal fistula recurrence of type Ⅲ esophageal atresia and examined through electronic bronchoscopy combined with injecting Methylene blue into stomach tube from Jan 2010 to Aug 2014. Male to female ratio was 4∶1. The age was 2～15 months, median age was 7.4 months. Results The 5 cases were found trachea membrane fistula by electronic bronchoscope, recurrent tracheoesophageal fistula was diagnosed with Methylene blue injected into stomach tube and overflowed from trachea membrane fistula. Examination time is 3～7 minutes, the average is 4.2 minutes. The 5 cases were confirmed by operation. Conclusion Electronic bronchoscopy combined with injecting Methylene blue into stomach tube to diagnose recurrent tracheoesophageal fistula is safe and feasible, the time is short and the diagnosis rate is high.