应用纤维支气管镜诊断和治疗小儿肺不张的效果探讨*

Application of fiberoptic bronchoscopy in diagnosis and treatment of atelectasis in children*

摘要:

摘要：目的 探讨纤维支气管镜在小儿肺不张诊断和治疗中的临床价值。方法 回顾性分析2013年1月－2016年12月在遵义市第一人民医院儿科行纤维支气管镜检查和治疗的86例肺不张患儿的临床资料，统计肺不张发生原因，观察治疗效果。结果 86例患儿的肺不张病因以炎症和异物最多，分别有39例（45.35%）和34例（39.53%）。不同年龄肺不张病因分布：0～1岁患儿肺不张病因以异物最多，2～3岁及以上患儿中异物和炎症所占比例较高；结核感染主要分布在0～3岁患儿中；痰液堵塞集中在4～6岁和7～9岁患儿中，10～12岁肺不张分布最少，主要为炎症和支气管扩张。经纤维支气管镜支气管肺泡灌洗治疗1个月后，总复张率为88.37%；治疗3个月后，总复张率为97.67%。结论 小儿肺不张病因复杂，其中炎症和异物是其主要病因，纤维支气管镜不仅能够帮助临床医生诊断小儿肺不张病因，还能够同时完成针对性治疗，在临床上具有应用价值。

Abstract:

Abstract: Objective To investigate the clinical value of fiberoptic bronchoscopy in diagnosis and treatment of atelectasis in children. Methods Clinical data of 86 children with atelectasis from January 2013 to December 2016 were retrospectively analyzed. The causes of atelectasis and treatment effects were observed. Results The main causes of atelectasis in 86 cases were inflammation and foreign bodies, respectively in 39 cases (45.35%) and in 34 cases (39.53%). Children aged 0 ~ 1 year with pulmonary atelectasis cause the most foreign body, children aged 2 ~ 3 years and above, the proportion of foreign body and inflammation in children. Etiological distribution of atelectasis at different ages: TB infection was mainly distributed in children aged 0 ~ 3 years, and the sputum congestion was concentrated in children aged 4 ~ 6 years and 7 ~ 9 years old. The distribution of atelectasis was the lowest in 10 ~ 12 years old, mainly inflammation and bronchiectasis. After 1 month of treatment with bronchoalveolar lavage, the total recovery rate was up to 88.37%. After treatment for a total of 3 months, the total recovery rate was about 97.67%. Conclusion The etiology of atelectasis in children is complicated, and the inflammation and foreign bodies are the main causes. The fiberoptic bronchoscopy can help the clinician to diagnose the cause of atelectasis in children, give targeted treatment and improve the clinical effect.