支气管肺泡灌洗术在儿童迁延性肺炎诊治中的作用

摘要

目的 探讨纤维支气管镜及支气管肺泡灌洗术在儿童迁延性肺炎诊治中的作用.方法 收集2009年1月-12月入院的迁延性肺炎患儿,对其中105例行纤维支气管镜检查及支气管肺泡灌洗,与40例未行此术的患儿进行对照分析.结果 105例行纤维支气管镜检查的患儿均显示不同程度的支气管内膜炎症,其中单纯性气管支气管内膜炎43例,62例同时存在呼吸道基础疾病,呼吸中心中气管支气管软化32例、气管支气管狭窄19例、支气管开口异常6例.支气管肺泡灌洗组治愈85例,治愈率80.95%;对照组治愈22例,治愈率55.00%.两组差异有统计学意义(P<0.005).结论 纤维支气管镜术及支气管肺泡灌洗术对儿童迁延性肺炎有重要的病因诊断和治疗价值,且安全性好.%Objective To explore the use of flexible bronchoscopy examination and bronchoalveolar lavage in diagnosis and treatment of childhood prolonged pneumonia. Methods A total of 145 cases with prolonged pneumonia between January 2009 and December 2009 were collected and among them 105 patients were given flexible bronchoscopy examination and bronchoalveolar lavage treatment. Results Flexible bronchoscopy examination showed that all of the 105 children with prolonged pneumonia had endobronchitis, in which 62 cases with other respiratory diseases. Among them, simple endobronchitis were 43 cases, tracheobronchomalacia were 32 cases, tracheobronchial stenosis were 19 cases, bronchial abnormal openings were 6 cases, tracheobronchial foreign body were 2 cases. Old pulmonary hemorrhage, bronchus dysplasia, laryngeal cartilage dysplasia was 1 case, respectively. In lavage group,85 cases were cured, 20 cases were improved; In control group, 22 cases were cured, 17 cases were improved, 1 case had no effect. There is statistical significance between lavage group and control group in effective rate( P ＜0.005). Conclusions Flexible bronchoscopy examination combined with broncboalveolar lavage treatment is a useful technology for both etiological diagnosis and treatment of prolonged pneumonia in children. It plays an irreplaceable role in the diagnosis of tracheobronchomalacia and it is safe.