肺泡灌洗术联合肺表面活性物质治疗 1 例儿童外源性脂质性肺炎并文献复习

目的:探讨经支气管镜肺泡灌洗术联合肺表面活性物质治疗 1 例儿童外源性脂质性肺炎的应用价值。 方法:收集我院收治的 1 例外源性脂质性肺炎患儿的临床诊疗资料,并进行文献分析。 结果:患儿意外吸入油性稀释液体后出现咳嗽、气促进行性加重,血氧饱和度降低,血炎症指标增高,胸部计算机断层扫描(CT)见双肺多发性病变,确诊外源性脂质性肺炎后及时予以经支气管镜肺泡灌洗术,并首次联合应用肺表面活性物质经支气管镜注入治疗,同时予以无创正压机械通气、抗感染、糖皮质激素雾化等治疗。 治疗后,患儿咳嗽、气促、低氧血症等临床表现及胸部影像学短期内明显好转。 结论:儿童外源性脂质性肺炎早期应用经支气管镜肺泡灌洗术联合肺表面活性物质治疗临床疗效好,有较大临床推广价值。

Alveolar Lavage Combined with Pulmonary Surfactant in the Treatment of a Child with Exogenous LipidPneumonia and Literature Review

Objective: To probe into the application value of bronchoscopic alveolar lavage combined with pulmonary surfactant in thetreatment of a child with exogenous lipid pneumonia. Methods: Clinical diagnosis and treatment data of a child with exogenous lipidpneumonia admitted into our hospital were collected, and the relevant literature were retrospectively analyzed. Results: Followingaccidental aspiration of oily diluent, the child developed cough, progressive aggravation of shortness of breath, decreased blood oxygensaturation, and increased blood inflammation indicators, chest computed tomography ( CT ) revealed multiple pulmonary lesionsbilaterally. After the diagnosis of exogenous lipid pneumonia, the child was given bronchoscopic alveolar lavage in time and combinedwith pulmonary surfactant for the first time. Meanwhile, non-invasive positive pressure ventilation, antibiotics, and glucocorticoidsatomization were given. Clinical manifestations of cough, shortness of breath, hypoxemia and chest imaging were improved significantlyin a short period of time. Conclusion: Early application of bronchoscopic alveolar lavage combined with pulmonary surfactant in childrenwith exogenous lipoid pneumonia has significant clinical efficacy and is of great clinical promotion value