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患有持续性呼吸道病变的小儿心血管疾病患者的支气管镜检查

Bronchoscopy in the Pediatric Cardiovascular Patient with Persistent Respiratory Pathology.

作者信息

Ariza-Jimenez Ana-Belen, Valverde Montoro Delia, Caro Aguilera Pilar, Perez Ruiz Estela, Perez Frias Francisco Javier

机构信息

Instituto Maimonides de Investigación Biomedica de Cordoba, Hospital Universitario Reina Sofia (Córdoba), Universidad de Cordoba, 14004 Cordoba, Spain.

Unidad de Cuidados Intensivos Pediatricos, Hospital Regional Universitario de Málaga (Materno-Infantil), 29011 Málaga, Spain.

出版信息

J Clin Med. 2025 Sep 19;14(18):6606. doi: 10.3390/jcm14186606.

Abstract

Patients with congenital heart disease can associate malformations. The most frequent complications are those related to the airways, which produce prolonged cardiovascular postoperative. : Describe pathology, bronchoscopy indications, and findings in patients with heart pathology and persistent breath failure to improve prognosis and determine an early treatment. : Retrospective descriptive study of bronchoscopies performed during 24 years in pediatric patients with congenital heart disease with surgery indication and persistent respiratory symptomatology. We performed 199 fibrobronchoscopies in 144 patients, with an average of 1.4 fibrobronchoscopies per patient. A total of 58% were male. The mean age was 27.5 months (5 days-13 years). Valvular disease was the most frequent congenital heart disease, followed by the transposition of large vessels. The most frequent indications were stridor (42.7%) and persistent atelectasis (24.6%), followed by extubation failure (12.4%) and pump output (6.2%). The majority of the findings were found in the upper airway (56%), with a clear predominance of malacias (32%), while in the lower airway, extrinsic compression was highlighted (42%). : Flexible fiberoptic bronchoscopy is a useful and rapid method for the diagnosis of airway malformations associated with congenital heart diseases that may have a relevant role in its management and prognosis.

摘要

先天性心脏病患者可能伴有多种畸形。最常见的并发症是与气道相关的并发症,这会导致心血管术后病程延长。目的:描述患有心脏疾病且持续呼吸衰竭患者的病理学、支气管镜检查指征及检查结果,以改善预后并确定早期治疗方案。方法:对24年间有手术指征且有持续呼吸道症状的先天性心脏病儿科患者进行的支气管镜检查进行回顾性描述性研究。我们对144例患者进行了199次纤维支气管镜检查,平均每位患者进行1.4次纤维支气管镜检查。其中58%为男性。平均年龄为27.5个月(5天至13岁)。瓣膜病是最常见的先天性心脏病,其次是大血管转位。最常见的指征是喘鸣(42.7%)和持续性肺不张(24.6%),其次是拔管失败(12.4%)和心输出量问题(6.2%)。大多数检查结果在上气道发现(56%),其中软化明显占优势(32%),而在下气道,外在压迫较为突出(42%)。结论:可弯曲纤维支气管镜检查是诊断与先天性心脏病相关的气道畸形的一种有用且快速的方法,在其管理和预后方面可能具有重要作用。

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