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儿科支气管镜检查:最新进展与临床挑战

Pediatric bronchoscopy: recent advances and clinical challenges.

作者信息

Goussard P, Pohunek P, Eber E, Midulla F, Di Mattia G, Merven M, Janson J T

机构信息

Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa.

Division of Pediatric Respiratory Diseases, Pediatric Department, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.

出版信息

Expert Rev Respir Med. 2021 Apr;15(4):453-475. doi: 10.1080/17476348.2021.1882854. Epub 2021 Feb 10.

Abstract

: During the last 40 years equipment has been improved with smaller instruments and sufficient size working channels. This has ensured that bronchoscopy offers therapeutic and interventional options.: We provide a review of recent advances and clinical challenges in pediatric bronchoscopy. This includes single-use bronchoscopes, endobronchial ultrasound, and cryoprobe. Bronchoscopy in persistent preschool wheezing and asthma is included. The indications for interventional bronchoscopy have amplified and included balloon dilatation, endoscopic intubation, the use of airway stents, whole lung lavage, closing of fistulas and air leak, as well as an update on removal of foreign bodies. Others include the use of laser and microdebrider in airway surgery. Experience with bronchoscope during the COVID-19 pandemic has been included in this review. PubMed was searched for articles on pediatric bronchoscopy, including rigid bronchoscopy as well as interventional bronchoscopy with a focus on reviewing literature in the past 5 years.: As the proficiency of pediatric interventional pulmonologists continues to grow more interventions are being performed. There is a scarcity of published evidence in this field. Courses for pediatric interventional bronchoscopy need to be developed. The COVID-19 experience resulted in safer bronchoscopy practice for all involved.

摘要

在过去40年里,设备不断改进,器械尺寸更小,工作通道大小合适。这确保了支气管镜检查提供治疗和介入选择。

我们综述了儿科支气管镜检查的最新进展和临床挑战。这包括一次性支气管镜、支气管内超声和冷冻探头。还包括持续性学龄前喘息和哮喘的支气管镜检查。介入性支气管镜检查的适应证有所增加,包括球囊扩张、内镜插管、气道支架的使用、全肺灌洗、瘘管和漏气的封闭,以及异物取出的最新情况。其他还包括在气道手术中使用激光和微型清创器。本次综述纳入了COVID-19大流行期间支气管镜检查的经验。检索了PubMed上关于儿科支气管镜检查的文章,包括硬支气管镜检查以及介入性支气管镜检查,重点回顾过去5年的文献。

随着儿科介入肺科医生的技术水平不断提高,越来越多的介入操作正在开展。该领域发表的证据很少。需要开发儿科介入性支气管镜检查课程。COVID-19的经验使所有相关人员的支气管镜检查操作更加安全。

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