局麻下儿童支气管镜及球囊扩张术在呼吸系统疾病中的临床应用

Clinical application of flexible bronchoscopy and balloon dilatation in pediatric respiratory diseases under local anesthesia

摘要:

目的：研究支气管镜及介入治疗对小儿呼吸系统疾病的诊断、治疗价值及其安全性。方法：438例患呼吸系统疾病患儿（男性236人，女性202人），年龄最小17 d，最大15岁，经局麻开展支气管镜术包括支气管镜下介入治疗。结果：经支气管镜检查确诊肺部感染311例，肺不张68例，反复咳喘36例，咯血6例，支气管异物6例，先天性支气管肺发育异常5例，支气管扩张症2例，纤毛不动综合征1例，肺部肿瘤1例，先天性免疫缺陷病2例。经支气管镜检查及局部冲洗或肺泡灌洗以及异物取出等处理后，379例显效，46例有效；5例炎症后狭窄行支气管镜下高压球囊扩张术，取得满意疗效。支气管镜检术中无严重并发症的发生。结论：局麻下行支气管镜术及球囊扩张术是安全、有效的，在儿科呼吸系统疾病的诊断和治疗上具有重要价值。

Abstract:

OBJECTIVE: To study the significance and safety of flexible bronchoscopy and balloon dilatation in the diagnosis and treatment of respiratory diseases in children. METHODS: A total of 438 children (236 males and 202 females) with respiratory diseases who were aged from 17 days to 15 years, were examined and/or treated by bronchoscopy (including bronchoscopic intervention) under local anesthesia. RESULTS: Of the 438 children, 311 were diagnosed with pulmonary infection, 68 with atelectasis, 36 with recurrent cough and asthma, 6 with hemoptysis of unknown origin, 6 with bronchial foreign body, 5 with congenital bronchopulmonary dysplasia, 2 with bronchiectasis, 1 with ciliary dyskinesia syndrome, 1 with lung tumor, and 2 with congenital immunodeficiency disease. After bronchoscopic examination, local flushing or bronchoalveolar lavage, and foreign body extraction, marked response was seen in 379 cases and response was seen in 46 cases. High-pressure balloon dilatation under bronchoscopy was performed in 5 cases with inflammatory stricture and achieved satisfying clinical effect. No severe complications were found in bronchoscopy. CONCLUSIONS: Bronchoscopy and balloon dilatation under local anesthesia is safe and effective for the diagnosis and treatment of respiratory diseases in children.