Johnston Cíntia, Carvalho Werther Brunow de
Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP.
Rev Assoc Med Bras (1992). 2008 Sep-Oct;54(5):455-60. doi: 10.1590/s0104-42302008000500021.
To review the literature about mechanisms, diagnosis and treatment of atelectasis in the pediatric patient.
An electronic data search was carried out in Medline and Scielo using the following inclusion criteria for articles published between 1960 and 2007 about: atelectasis etiology, physiopathology, functional consequences, evaluation, prevention, treatment and complications, in pediatrics. The used key words were atelectasis, children, pediatrics, mucus plugs, chest physiotherapy;
45 pulmonary atelectasis articles were analyzed, 17 of them in pediatrics. Of the pediatric, 13 were case series, 3 literature reviews and one a case report. This demonstrates that there were few articles on atelectasis during the reviewed period and that these articles were at the D and E evidence level.
No clinical trials were performed to identify s the most efficient treatment for atelectasis in the pediatric patient. Although clinical practice for treatment of atelectasis has evolved, mostly due to improvement of bronchoscopy and chest physiotherapy techniques, there is still a need to perform randomized clinical trials to address treatment of atelectasis in the pediatric patient.
回顾有关小儿肺不张的机制、诊断及治疗的文献。
在Medline和Scielo数据库中进行电子数据检索,检索1960年至2007年间发表的关于小儿肺不张的病因、生理病理学、功能后果、评估、预防、治疗及并发症的文章,检索关键词为肺不张、儿童、儿科、黏液栓、胸部物理治疗。
分析了45篇肺不张相关文章,其中17篇为儿科相关文章。儿科文章中,13篇为病例系列,3篇为文献综述,1篇为病例报告。这表明在所回顾的时期内,关于肺不张的文章较少,且这些文章处于D级和E级证据水平。
尚未进行临床试验以确定小儿肺不张最有效的治疗方法。尽管肺不张的临床治疗方法有所发展,主要得益于支气管镜检查和胸部物理治疗技术的改进,但仍需要进行随机临床试验以解决小儿肺不张的治疗问题。