[纤维支气管镜在104例小儿肺不张诊治中的应用]

Zhang Dai-jia, Zhao De-yu, Liang Hui, Tian Man, Han Qing

Division of Pediatric Pulmonary Diseases, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing 210008, China.

Zhonghua Er Ke Za Zhi. 2010 Oct;48(10):767-70.

OBJECTIVE

To evaluate the value of flexible fiberoptic bronchoscopy in diagnosis and treatment of pulmonary atelectasis in children.

METHOD

Totally 104 patients with pulmonary atelectasis, who were admitted to this department, received flexible fiberoptic bronchoscopy from January 2006 to May 2010, were enrolled in a retrospective analysis.

RESULT

The analysis on causes of pulmonary atelectasis showed that 76 cases (73%) of the 104 patients had sputum obstructions, which was the main cause of atelectasis. Thirteen cases (13%) had bronchopulmonary dysplasia, 9 cases among these were infants. Twelve cases (12%) had foreign body aspiration, 8 cases among these were under the age of 3-year. After flexible fiberoptic bronchoscopy, 100 cases got expansion of pulmonary atelectasis. Sixty-five of the sputum obstruction cases got atelectasis reexpansion after one time of flexible fiberoptic bronchoscopy. Eight of the sputum obstruction cases got atelectasis reexpansion after two times of flexible fiberoptic bronchoscopy. Two of the sputum obstruction cases got atelectasis reexpansion after three times of flexible fiberoptic bronchoscopy. The rate of atelectasis reexpansion after one time of alveolus lavement was higher in the cases whose courses of disease were under 3 weeks, than in the cases whose courses of disease were beyond 3 weeks.

CONCLUSION

Etiology of pulmonary atelectasis varied at different age. The morbidity of bronchopulmonary dysplasia was high in infants. Foreign body aspiration was the common cause of pulmonary atelectasis in children from 1 to 3-year of age. Sputum obstruction was the main cause of pulmonary atelectasis in over 3-year-old children. Most cases got atelectasis reexpansion after alveolar lavage. The patients who had shorter course of disease might have higher rate of atelectasis reexpansion after alveolar lavage once. Flexible fiberoptic bronchoscopy plays an important role in diagnosis and treatment of pulmonary atelectasis.

目的

评估纤维支气管镜在小儿肺不张诊断与治疗中的价值。

方法

回顾性分析2006年1月至2010年5月在本科住院并接受纤维支气管镜检查的104例肺不张患儿的临床资料。

结果

肺不张病因分析显示，104例患儿中76例（73%）为痰液阻塞，是肺不张的主要原因；13例（13%）为支气管肺发育不良，其中9例为婴儿；12例（12%）为异物吸入，其中8例年龄在3岁以下。纤维支气管镜检查后，100例肺不张患儿肺复张。痰液阻塞患儿中，65例经1次纤维支气管镜检查后肺复张，8例经2次纤维支气管镜检查后肺复张，2例经3次纤维支气管镜检查后肺复张。病程在3周以内的患儿经1次肺泡灌洗后肺复张率高于病程超过3周的患儿。