纤维支气管镜对先天性心脏病患儿呼吸道病变的诊治价值

目的探讨纤维支气管镜对先天性心脏病患儿呼吸道病变的诊治价值。方法对15例先天性心脏病住院患儿进行了共18次支气管镜检查，其中6例进行了支气管肺泡灌洗。结果纤维支气管镜检查发现炎症反应14例，气管或支气管狭窄9例，气管或支气管软化5例，右上气管性支气管4例，肺不张3例，气管憩室1例，声门麻痹1例，会厌软化1例。6例进行了支气管肺泡灌洗，5例治愈；1例肺不张经冲洗后3d肺不张完全恢复。结论纤维支气管镜检查是评估先天性心脏病患儿气道情况的一种很好手段。炎症反应、气管或支气管狭窄、气管或支气管软化在先天性心脏病患儿中较为常见．结合支气管肺泡灌洗技术能起到治疗的效果。纤维支气管镜检查的并发症主要为可纠正的低氧血症。因此对先天性心脏病患儿进行纤维支气管镜检查是比较安全的。

Diagnostic and therapeutic value of bronchofiberoscopic examination in respiratory comorbidity of congenital heart disease children

Objective To evaluate the diagnostic and therapeutic value of bronchofiberoscopic examination in respiratory comorbidity of congenital heart disease children. Methods Bronchofiberoscopic examination was performed in 15 children for altogether 18 times and 6 children were treated with bronchoalveolar lavage simultaneously. Results Bronchofiberoscopic examination indicated airway inflammation in 14 cases, tracheobronchial stenosis in 9 cases, tracheomalacia or bronchomalacia in 5 cases, tracheal bronchus in 4 cases, atelectasis in 3 cases, tracheal diverticulum , glottis paralysis and epiglottis malacoma in 1 case respectively. Among the six children with bronchoalveolar lavage, five were cured and one was free from atelectasis 3 days after therapy. Conclusion Bronchofiberoscopic examination is useful in assessing respiratory comorbidity of congenital heart disease children. Bronchofiberoscopically, inflammation, tracheobronchial stenosis and tracheobronchial malacia are common in children with congenital heart disease. Bronchoalveolar lavage has therapeutic effect as well. Futhermore, hypoxemia, the major complication during bronchofiberoscopic examination, is correctable. Thus, bronchofiberoscope is relatively safe in children with congenital heart disease.