170例有慢性呼吸道症状儿童的支气管内活检安全性
Safety of endobronchial biopsy in 170 children with chronic respiratory symptoms.
作者信息
Salva P S, Theroux C, Schwartz D
机构信息
Pediatric Pulmonology of Western New England, Springfield, Massachusetts, USA.
出版信息
Thorax. 2003 Dec;58(12):1058-60. doi: 10.1136/thorax.58.12.1058.
BACKGROUND
There is a paucity of bronchial biopsy data in children. A major limitation is concern over the safety of the procedure. This paper reports the results of efforts to develop a method that is safe and provides adequate specimen for evaluation.
METHODS
170 children aged 2.5 to 16 years with chronic respiratory symptoms were studied under general anaesthesia in an outpatient surgery setting. Bronchoalveolar lavage and biopsies were obtained using a 4.9 mm flexible bronchoscope through a laryngeal mask airway. At least three bioipsies were taken.
RESULTS
No patient required topical adrenaline to control bleeding, nor was there a change in the state of any of the patients. There were no episodes of pneumothorax, haemoptysis, pneumonia, or significant fever. All children less than four years old received a single dose of antibiotic intravenously after the procedure. The average length of time for the procedure was 12 minutes (range 6 to 27). Recovery time averaged 90 minutes. The limiting factor was the ability of the child's airway to accomodate the bronchoscope.
CONCLUSIONS
This report should encourage clinicians to incorporate endobronchial biopsy into the evaluation of children with difficult respiratory problems.
背景
儿童支气管活检数据匮乏。一个主要限制因素是对该操作安全性的担忧。本文报告了开发一种安全且能提供足够标本用于评估的方法的努力结果。
方法
对170名年龄在2.5至16岁、有慢性呼吸道症状的儿童在门诊手术环境下进行全身麻醉研究。使用4.9毫米柔性支气管镜通过喉罩气道进行支气管肺泡灌洗和活检。至少采集三次活检标本。
结果
没有患者需要局部使用肾上腺素来控制出血，患者的状态也没有变化。没有发生气胸、咯血、肺炎或明显发热的情况。所有4岁以下儿童在术后静脉注射了单剂量抗生素。该操作的平均时长为12分钟（范围6至27分钟）。恢复时间平均为90分钟。限制因素是儿童气道容纳支气管镜的能力。
结论
本报告应鼓励临床医生将支气管内活检纳入对有复杂呼吸道问题儿童的评估中。
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