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全身麻醉下硬质通气支气管镜治疗小儿肺炎所致肺不张33例回顾

Rigid ventilation bronchoscopy under general anesthesia for treatment of pediatric pulmonary atelectasis caused by pneumonia: A review of 33 cases.

作者信息

Wu Kuo-Hwa, Lin Chih-Fu, Huang Chun-Jen, Chen Chien-Chuan

机构信息

Department of Anesthesiology, Mackay Memorial Hospital, Taipei, Taiwan.

出版信息

Int Surg. 2006 Sep-Oct;91(5):291-4.

Abstract

Pediatric pulmonary atelectasis caused by pneumonia is a common disease. If the mucus plugs or secretions occlude the bronchial trees and cannot be cleaned by coughing, suctioning, or vigorous respiratory and physical therapy, is rigid ventilation bronchoscopy (V-B) effective and safe as a therapeutic procedure in such patients? We collected 33 cases of pediatric pulmonary atelectasis that were treated by rigid V-B under general anesthesia for removal of the mucus plugs or foreign bodies. During the rigid V-B with lung lavage performed by experienced bronchoscopists, the oxygen saturation was maintained in good condition. No disastrous complications were noted. Sixty-four percent (21/33) of those with pediatric pulmonary atelectasis had significant improvement in either oxygen saturation or chest radiography within 72 hours. We conclude that when the traditional treatment in pediatric pulmonary atelectasis was ineffective, rigid V-B might be an adequate and safe procedure to remove the mucus plugs and restore pulmonary function.

摘要

肺炎引起的小儿肺不张是一种常见疾病。如果黏液栓或分泌物阻塞支气管树,且无法通过咳嗽、吸痰或积极的呼吸及物理治疗清除,那么硬质通气支气管镜检查(V-B)作为此类患者的一种治疗方法是否有效且安全呢?我们收集了33例在全身麻醉下接受硬质V-B治疗以清除黏液栓或异物的小儿肺不张病例。在由经验丰富的支气管镜医师进行的伴有肺灌洗的硬质V-B过程中,氧饱和度维持良好。未观察到严重并发症。64%(21/33)的小儿肺不张患者在72小时内氧饱和度或胸部X线检查有显著改善。我们得出结论,当小儿肺不张的传统治疗无效时,硬质V-B可能是清除黏液栓和恢复肺功能的一种合适且安全的方法。

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