中国妇幼健康研究
中國婦幼健康研究
중국부유건강연구
CHINESE JOURNAL OF MATERNAL AND CHILD HEALTH RESEARCH
2014年
5期
783-785,786
,共4页
余宏川%孙欣荣%辛丽红%王立军
餘宏川%孫訢榮%辛麗紅%王立軍
여굉천%손흔영%신려홍%왕립군
纤维支气管镜%儿童%喘息%病因
纖維支氣管鏡%兒童%喘息%病因
섬유지기관경%인동%천식%병인
fiberoptic bronchoscope%children%asthma%etiopathogenisis
目的：探讨纤维支气管镜（纤支镜）术对儿科反复喘息性疾病的诊断及治疗意义。方法回顾2012年10月至2013年4月西安市儿童医院收治反复喘息的患儿211例，按年龄分为＜1岁组、1～3岁组和＞3～12岁，采用纤维支气管镜检查，对检查结果进行分析总结。结果在211例反复喘息患儿中，镜检结果按发生频率依次为：气道发育畸形、气管支气管内膜炎症、气管支气管异物。其中气道畸形100例（47．4％），包括气管支气管狭窄43例（20．4％），喉气管支气管软化40例（20．0％），气管食管瘘7例（3．3％），会厌囊肿6例（2．8％），支气管肺发育不良4例（1．9％）；气管支气管内膜炎症69例（32．7％），包括支气管内膜结核10例（4．7％）；支气管异物42例（19．9％）。不同年龄组导致喘息的气道因素有显著差异（χ2＝55．304，P＜0．001）。＞3～12岁及1～3岁组气管内因素为喘息主要病因，而在＜1岁组，气管外因素及气管壁因素，尤其后者是导致喘息的主要病因。不同年龄组喘息患儿的镜检结果也有显著差异（χ2＝72．064，P＜0．001）。在＜1岁组，气道畸形检出率高，而＞3～12岁气管内膜炎症检出率高，1～3岁组支气管异物及气管内膜炎症检出率高。结论纤支镜对喘息性患儿的病因诊断和治疗有重要作用。
目的：探討纖維支氣管鏡（纖支鏡）術對兒科反複喘息性疾病的診斷及治療意義。方法迴顧2012年10月至2013年4月西安市兒童醫院收治反複喘息的患兒211例，按年齡分為＜1歲組、1～3歲組和＞3～12歲，採用纖維支氣管鏡檢查，對檢查結果進行分析總結。結果在211例反複喘息患兒中，鏡檢結果按髮生頻率依次為：氣道髮育畸形、氣管支氣管內膜炎癥、氣管支氣管異物。其中氣道畸形100例（47．4％），包括氣管支氣管狹窄43例（20．4％），喉氣管支氣管軟化40例（20．0％），氣管食管瘺7例（3．3％），會厭囊腫6例（2．8％），支氣管肺髮育不良4例（1．9％）；氣管支氣管內膜炎癥69例（32．7％），包括支氣管內膜結覈10例（4．7％）；支氣管異物42例（19．9％）。不同年齡組導緻喘息的氣道因素有顯著差異（χ2＝55．304，P＜0．001）。＞3～12歲及1～3歲組氣管內因素為喘息主要病因，而在＜1歲組，氣管外因素及氣管壁因素，尤其後者是導緻喘息的主要病因。不同年齡組喘息患兒的鏡檢結果也有顯著差異（χ2＝72．064，P＜0．001）。在＜1歲組，氣道畸形檢齣率高，而＞3～12歲氣管內膜炎癥檢齣率高，1～3歲組支氣管異物及氣管內膜炎癥檢齣率高。結論纖支鏡對喘息性患兒的病因診斷和治療有重要作用。
목적：탐토섬유지기관경（섬지경）술대인과반복천식성질병적진단급치료의의。방법회고2012년10월지2013년4월서안시인동의원수치반복천식적환인211례，안년령분위＜1세조、1～3세조화＞3～12세，채용섬유지기관경검사，대검사결과진행분석총결。결과재211례반복천식환인중，경검결과안발생빈솔의차위：기도발육기형、기관지기관내막염증、기관지기관이물。기중기도기형100례（47．4％），포괄기관지기관협착43례（20．4％），후기관지기관연화40례（20．0％），기관식관루7례（3．3％），회염낭종6례（2．8％），지기관폐발육불량4례（1．9％）；기관지기관내막염증69례（32．7％），포괄지기관내막결핵10례（4．7％）；지기관이물42례（19．9％）。불동년령조도치천식적기도인소유현저차이（χ2＝55．304，P＜0．001）。＞3～12세급1～3세조기관내인소위천식주요병인，이재＜1세조，기관외인소급기관벽인소，우기후자시도치천식적주요병인。불동년령조천식환인적경검결과야유현저차이（χ2＝72．064，P＜0．001）。재＜1세조，기도기형검출솔고，이＞3～12세기관내막염증검출솔고，1～3세조지기관이물급기관내막염증검출솔고。결론섬지경대천식성환인적병인진단화치료유중요작용。
Objective To explore the significance of fiberoptic bronchoscopy on the diagnosis and treatment of pediatric recurrent asthmatic disease.Methods From October 2012 to April 2013 211 cases of children with recurrent asthmatic disease treated in Children’ s Hospital of Xi’ an were divided into 3 groups by age, <1 year old group, 1-3 years old group and >3-12 years old group.They underwent fiberoptic bronchoscopy, and the results were analyzed.Results In 211 cases of children with recurrent wheeze, the results of bronchoscopy in the order of frequency were airway malformation, tracheal intima inflammation, and tracheal foreign body.There were 100 cases of airway malformation (47.4%) , including 43 cases of tracheal and bronchial stenosis (20.4%) , 40 cases of throat, trachea and bronchial softening (20.0%), 7 cases of tracheoesophageal fistula (3.3%), 6 cases of epiglottis cyst (2.8%), and 4 cases of bronchial and pulmonary dysplasia (1.9%).There were 69 cases of tracheal and bronchial intima inflammation (32.7%),including 10 cases of bronchial intima tuberculosis (4.7%).And there were 42 cases of bronchial foreign body (19.9%).The airway factors leading to wheeze were significantly different among different groups (χ2 =55.304,P<0.001) .The primary cause leading to wheeze in >3-12 years old group and 1-3 years old group was endotracheal factor, but the extratracheal factors and the factor of bronchial wall, especially the latter one, was the main cause of asthma in the <1 year old group.Significant differences were found in the results of fiberoptic bronchoscopy among 3 groups (χ2 =72.064, P<0.001).In the <1 year old group, the frequency of airway malformation was high, in >3-12 years old group the frequency of tracheal intima inflammation was high, and in 1-3 years old group the frequencies of bronchial foreign bodies and tracheal intima inflammation were high.Conclusion Fiberoptic bronchoscopy plays an important role in etiology diagnosis and treatment for asthmatic children.
