García-Casillas M A, Matute J A, Romero R, Berchi F J, Sánchez R, Vázquez J
Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, C/Doctor Castelo, 49 28009 Madrid.
Cir Pediatr. 2002 Apr;15(2):52-6.
The aim of our study is to asses the risks and complications in bronchoscopies at Neonatal Intensive Care Units (NICU). Between 1991 and 1999, we performed 142 bronchoscopies at the NICU. The mean age was 1.6 +/- 1.4 months (2 days-6 months) and mean weight was 2.5 +/- 1 kg (530 g-4.7 kg). We analysed the complications, arterial oxygen saturation and inspired oxygen fraction (FiO2) during bronchoscopy and we compared them related to weight, type of anesthesia and type of bronchoscope used. Mean basal saturation was 92 +/- 8.9% and end saturation was 92.8 +/- 10%. The basal FiO2 was 0.5 +/- 0.3 (0.21-1). There were more complications in patients weighting less than 1500 g and in those procedures made with rigid bronchoscopy (p < 0.05). There were no differences according to the anesthesia. Children who weight fewer than 1500 g and those who underwent rigid bronchoscopy suffered a descent in arterial oxygen saturation and needed higher FiO2 (p < 0.05). Bronchoscopy is a very useful technique and it is well tolerated in neonatal patients. We conclude that flexible fiberoptic bronchoscopy is safer than the rigid bronchoscopy, specially in children fewer under 1500 g.
我们研究的目的是评估新生儿重症监护病房（NICU）支气管镜检查的风险和并发症。1991年至1999年间，我们在NICU进行了142例支气管镜检查。平均年龄为1.6±1.4个月（2天至6个月），平均体重为2.5±1千克（530克至4.7千克）。我们分析了支气管镜检查期间的并发症、动脉血氧饱和度和吸入氧分数（FiO2），并将它们与体重、麻醉类型和所用支气管镜类型进行了比较。平均基础饱和度为92±8.9%，结束时饱和度为92.8±10%。基础FiO2为0.5±0.3（0.21至1）。体重小于1500克的患者以及使用硬支气管镜进行的操作中并发症更多（p<0.05）。根据麻醉情况没有差异。体重小于1500克的儿童以及接受硬支气管镜检查的儿童动脉血氧饱和度下降，需要更高的FiO2（p<0.05）。支气管镜检查是一项非常有用的技术，新生儿患者对其耐受性良好。我们得出结论，柔性纤维支气管镜比硬支气管镜更安全，特别是对于体重不足1500克的儿童。
