纤维支气管镜细胞刷在儿童危重症塑型性支气管炎中的应用

Clinical application of bronchoscope cytobrush in children with critical plastic bronchitis

摘要:

目的 评价纤维支气管镜细胞刷在儿童危重症塑型性支气管炎（PB）痰栓取出中的应用价值。方法 回顾性分析收住该院儿童重症监护室（PICU）收治的5例危重症PB患儿的临床资料，在全身麻醉配合呼吸机辅助通气的情况下，应用纤维支气管镜配合细胞刷取出塑型性痰栓。结果 5例患儿均能通过纤维支气管镜手术取出塑型性痰栓，手术过程中患儿生命体征稳定，经皮动脉血氧饱和度（SpO₂）均能维持在80%以上，5例患儿术后继续在PICU行呼吸机辅助通气，术后2 d内均能撤掉呼吸机。结论 对于危重症PB患儿，如果病情需要，可以在呼吸机辅助通气和全身麻醉情况下，使用纤维支气管镜配合细胞刷取出塑型性痰栓，以提高手术效率，减少损伤。

Abstract:

Objective To investigate the effect of bronchoscope cytobrush on the removal of mucus plug in children with critical plastic bronchitis (PB).Methods The clinical data of 5 children with critical PB were retrospectively analyzed. Fiberoptic bronchoscope with combination of cytobrush and lavage was applied to the patients under general anesthesia and ventilator-assisted ventilation to remove the mucus plug in the bronchus.Results Mucus plug in the bronchus of 5 children in PICU were successfully removed by fiberoptic bronchoscopy, remained the stable condition during the operation procedure, including the vital signs and percutaneous arterial oxygen saturation (SpO₂) (>80%). After bronchoscopy, all children received ventilator-assisted ventilation in PICU for within 2 days.Conclusion Fiberoptic bronchoscope with cytobrush could be one of the effective methods to remove mucus plug in the bronchus of children under general anesthesia and ventilation, with higher efficiency but less injury.