CAJ | 학술논문

目的：探讨小儿电子支气管镜术的临床应用，评估电子支气管镜在儿科尤其是呼吸系统疾病中的诊疗价值和安全性。方法采用回顾性研究方法，对2012年4月~2013年3月在我院行电子支气管镜术的116例患儿进行分析总结。结果本组116例患儿存在不同程度气管支气管内膜炎症86例，其中同时存在喉气管支气管软化12例；先天性气道狭窄2例；气道外压畸形3例；先天性食管气管漏4例；肺含铁血黄素沉着症2例；支气管异物11例；会厌囊肿4例；声门下乳头状瘤1例；杓状软骨脱位1例；支气管结核2例。116例患儿中110例进行支气管肺泡灌洗，灌洗液中细菌培养阳性8例，肺炎支原体DNA阳性10例，涂片发现真菌4例，结核杆菌DNA阳性2例。116例患儿共119次电子支气管镜检查中，1例患儿气道痉挛并致呼吸、心率减慢、经皮血氧饱和度下降，经暂停操作，增加氧流量、静脉滴注甲基泼尼松龙，雾化吸入异丙托溴铵、布地奈德、利多卡因等处理后好转，2d后全麻下再次行电子支气管镜术，操作顺利；其余病例操作过程顺利、安全。术后一过性发热4例，鼻出血2例。结论支气管镜术对小儿呼吸系统疾病有重要的诊疗价值，操作安全、方便，值得在儿科临床推广使用。
목적：탐토소인전자지기관경술적림상응용，평고전자지기관경재인과우기시호흡계통질병중적진료개치화안전성。방법채용회고성연구방법，대2012년4월~2013년3월재아원행전자지기관경술적116례환인진행분석총결。결과본조116례환인존재불동정도기관지기관내막염증86례，기중동시존재후기관지기관연화12례；선천성기도협착2례；기도외압기형3례；선천성식관기관루4례；폐함철혈황소침착증2례；지기관이물11례；회염낭종4례；성문하유두상류1례；표상연골탈위1례；지기관결핵2례。116례환인중110례진행지기관폐포관세，관세액중세균배양양성8례，폐염지원체DNA양성10례，도편발현진균4례，결핵간균DNA양성2례。116례환인공119차전자지기관경검사중，1례환인기도경련병치호흡、심솔감만、경피혈양포화도하강，경잠정조작，증가양류량、정맥적주갑기발니송룡，무화흡입이병탁추안、포지내덕、리다잡인등처리후호전，2d후전마하재차행전자지기관경술，조작순리；기여병례조작과정순리、안전。술후일과성발열4례，비출혈2례。결론지기관경술대소인호흡계통질병유중요적진료개치，조작안전、방편，치득재인과림상추엄사용。
Objective To explore the clinical application of electronic bronchoscopy in children, Evaluate the value and safety of electronic bronchoscopy in the diagnosis and treatment of pediatric especial y in respiratory diseases. Methods Clinical data from 116 pediatric patients by electronic bronchoscopy in our hospital from April 2012 to March 2013. Results In 116 patients, there are dif erent degrees of bronchial inflammation in 86 cases,that contain 12 cases of laryngeal, tracheo,or broncho malacia, congenital tracheal stenosis in 2 cases; and there are 3 cases of airway pressure deformity, 4 cases of congenital tracheoesophageal fistula, in 2 cases of Pulmonary Hemosiderosis; 11 cases of Bronchial foreign body; 4 cases of Epiglot ic Cyst; 1 cases of Subglot ic papil ary tumor; 1 cases of Arytenoid Dislocation; 2 cases of Endobronchial Tuberculosis. 116 cases in 110 cases of bronchial alveolar lavage, Bacterial culture was positive in 8 cases, MP DNA was positive in 10 cases, smear showed that fungus in 4 cases, TB DNA was positive in 10 cases. 116 patients was performed electronic bronchoscopy 119 times,1 cases of children with airway spasm, then respiratory rate and heart rate were induced , SPO2 were declined.We suspend the operation, increase oxygen flow, Intravenous injection of methyl prednisolone. Ipratropium bromide, budesonide, lidocaine inhalation.The patien then were recovery.For 2 days later, under the general anesthesia, we do the electronic bronchoscopy for the patien again,and the operation is smoothly. The rest cases operation process smoothly and safety.There are 4 cases in a transient fever,and 2 cases in nasal bleeding after operation. Conclusions Bronchoscopy has important value in diagnosis and treatment of children with respiratory diseases, and the operation is safe and convenient. Electronic bronchoscopy is worth using in the pediatric extension.