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目的探讨支原体肺炎在纤维支气管镜镜下形态学表现特点及介入治疗支原体肺炎的效果。方法收集1996-01—2006-06在北京儿童医院就诊的住院患儿170例,临床确诊为支原体肺炎,经纤维支气管镜检查并予以病变局部介入治疗。结果所有患儿在纤维支气管镜下均可见黏膜粗糙、肿胀、分泌物附着,部分患儿有血管走行粗重(117例,68.8%),纵行皱褶(65例,38.2%),黏膜花斑样改变(24例,14.1%),黏膜腺体小结样突起(19例,11.2%),黏膜糜烂(5例,2.9%);管腔开口炎性狭窄(94例,55.3%),甚至闭塞(27例,15.9%),段支气管通气不畅(120例,70.6%);管腔分泌物多数呈半透明或灰白黏稠状,部分形成黏液栓阻塞细支气管(46例,27.1%)。经过治疗,所有病例均有改善,141例(82.9%)患儿介入治疗1~4次,最多10次。结论支原体肺炎可并发肺不张;纤维支气管镜下主要特点为支气管黏膜病变和黏液栓阻塞,管腔开口炎性狭窄、闭塞,段支气管通气不畅;早期经纤维支气管镜诊治有利于缩短病程。

Flexible bronchoscope diagnosis and treatment of mycoplasma pneumonia in children.

??AbstractObjectiveTo probe morphologic features of mycoplasma pneumonia under flexible bronchoscope.To observe interposing therapeutic effect of mycoplasma pneumonia by bronchoscopy.MethodsThe study was performed in 170 patients with mycoplasma pneumonia.The blood mycoplasma antibody was 1??320 at least.The radiographic sternum of 68.2% patients showed atelectasis,and 22.9% showed pleural effusion or pleurisy.All patients were performed flexible bronchoscopy.ResultsUnder flexible bronchoscope,it was obvious in all patients that bronchial mucosa roughness,swelling,and secretion attachment were shown.Meanwhile in some patients bronchoscopy showed blood vessel becoming gross(68.8%),upright crease(38.2%),mucosa piebald shape(14.1%),mucosa crypts nodule(11.2%),mucosa anabrosis(2.9%).Some patients had tube debouchement inflammatory stenosis(55.3%),even occlusion(15.9%),segmental bronchi ventilation lack(70.6%).Most of intraluminal secretion showed translucent or hoar dope.Some formed mucous plug blocking bronchi(27.1%).Through therapy,all patients got improvement.The times of intervention therapy were from one to four in 82.9% of the patients,at most ten.ConclusionMycoplasma pneumonia can supervene with atelectasis.Under flexible bronchoscope,main features of mycoplasma pneumonia are bronchial mucosal lesion,mucous plug blocking,tube debouchement inflammatory stenosis and occlusion,and segmental bronchi ventilation lack.It is beneficial to shorten course of disease by early applying flexible bronchoscope by diagnose and treat patients with mycoplasma pneumonia.