CAJ | 학술논문

目的：探究纤维支气管镜在小儿肺不张病因诊断和治疗中的应用价值。方法选取2011年5月—2014年8月东莞市石龙人民医院收治的肺不张患儿210例，均采用纤维支气管镜检查患儿肺不张病因，将其中经支气管肺泡灌洗治疗的156例患儿作为灌洗治疗组，未经支气管肺泡灌洗治疗的54例患儿作为未灌洗治疗组。分析患儿病变部位、各年龄段病因构成，随访观察1、2、3个月两组患儿肺复张情况。结果纤维支气管镜检查发现病变194例，未见明显异常16例。纤维支气管镜显示病变为右侧全肺22例（11.34％），右上叶18例（9.28％），右中叶98例（50.52％），右下叶32例（16.49％），左侧全肺4例（2.06％），左上叶12例（6.19％），左下叶8例（4.12％）。炎症（35.71％）、异物（22.86％）和非特异性狭窄（12.86％）为肺不张患儿的主要病因；＜1岁患儿的主要病因为炎症（41.67％）、异物（13.89％）、非特异性狭窄（16.67％）和软化（16.67％）；1～3岁患儿的主要病因为异物（39.77％）、炎症（18.18％）、非特异性狭窄（13.64％）和分支开口异常（9.09％）；4～6岁患儿的主要病因为炎症（46.15％）、异物（15.39％）和支气管扩张（11.54％）；＞6岁患儿的主要病因为炎症（53.33％）、非特异性狭窄（11.66％）和异物（6.67％）。随访1、2、3个月，灌洗治疗组患儿肺复张情况均优于未灌洗治疗组（P＜0.05）。结论小儿肺不张的病因构成多样，其中炎症、异物和非特异性狭窄为主要病因，纤维支气管镜在小儿肺不张病因诊断和治疗中具有较高的应用价值。
목적：탐구섬유지기관경재소인폐불장병인진단화치료중적응용개치。방법선취2011년5월—2014년8월동완시석룡인민의원수치적폐불장환인210례，균채용섬유지기관경검사환인폐불장병인，장기중경지기관폐포관세치료적156례환인작위관세치료조，미경지기관폐포관세치료적54례환인작위미관세치료조。분석환인병변부위、각년령단병인구성，수방관찰1、2、3개월량조환인폐복장정황。결과섬유지기관경검사발현병변194례，미견명현이상16례。섬유지기관경현시병변위우측전폐22례（11.34％），우상협18례（9.28％），우중협98례（50.52％），우하협32례（16.49％），좌측전폐4례（2.06％），좌상협12례（6.19％），좌하협8례（4.12％）。염증（35.71％）、이물（22.86％）화비특이성협착（12.86％）위폐불장환인적주요병인；＜1세환인적주요병인위염증（41.67％）、이물（13.89％）、비특이성협착（16.67％）화연화（16.67％）；1～3세환인적주요병인위이물（39.77％）、염증（18.18％）、비특이성협착（13.64％）화분지개구이상（9.09％）；4～6세환인적주요병인위염증（46.15％）、이물（15.39％）화지기관확장（11.54％）；＞6세환인적주요병인위염증（53.33％）、비특이성협착（11.66％）화이물（6.67％）。수방1、2、3개월，관세치료조환인폐복장정황균우우미관세치료조（P＜0.05）。결론소인폐불장적병인구성다양，기중염증、이물화비특이성협착위주요병인，섬유지기관경재소인폐불장병인진단화치료중구유교고적응용개치。
Objective To investigate the application value of fiber bronchoscope in the etiological diagnosis and treatment in children with pulmonary atelectasis.Methods A total of 210 children with pulmonary atelectasis were selected in the Third People′s Hospital of Dongguan from May 2011 to August 2014, all of them were underwent fiber bronchoscope examination to find out the aetiological agent, and they were divided into A ( treated by bronchoalveolar lavage, n=156) group and B group ( not treated by bronchoalveolar lavage, n =54 ) according to the therapeutic methods.Diseased regions, aetiological agents in different age groups were analyzed, and pulmonary reexpansion condition was observed at 1-month, 2-month, 3-month of fellow -up. Results By fiber bronchoscope examination, 194 children found lesions, 16 cases did not.Diseased regions: 22 cases with whole right lung ( accounted for 11.34%) , 18 cases with right upper lobe ( accounted for 9.28%) , 98 cases with right middle lobe ( accounted for 50.52%) , 32 cases with right lower lobe ( accounted for 16.49%) , 4 cases with whole left lung ( accounted for 2.06%) , 12 cases with left upper lobe ( accounted for 6.19%) , 8 cases with left lower lobe ( accounted for 4.12%) . Inflammation ( 35.71%) , foreign bodies ( 22.86%) and nonspecific narrow (12.86%) were the main aetiological agents.In children less than 1 -year old, inflammation ( 41.67%) , foreign bodies (13.89%), nonspecific narrow (16.67%) and malacia (16.67%) were the main aetiological agents; in children aged between 1 -and 3 -year old, foreign bodies ( 39.77%) , inflammation ( 18.18%) , nonspecific narrow ( 13.64%) and abnormal openings of bronchial tree ( 9.09%) were the main aetiological agents; in children aged between 4-and 6 -year old, inflammation (46.15%), foreign bodies (15.39%) and bronchiectasia (11.54%) were the main aetiological agents;in children aged over 6 years old, inflammation ( 53.33%) , nonspecific narrow ( 11.66%) and foreign bodies ( 6.67%) were the main aetiological agents.At 1-month, 2-month, 3-month of fellow-up, the pulmonary reexpansion condition of A group was statistically significantly better than that of B group, respectively (P<0.05).Conclusion The aetiological agent of children with pulmonary atelectasis is various, inflammation, foreign bodies and nonspecific narrow are the main aetiological agents; fiber bronchoscope has application value in the etiological diagnosis and treatment in children with pulmonary atelectasis.