硬支气管镜下小儿肺不张的诊疗分析

目的通过硬支气管镜检术明确小儿肺不张的病因,评价支气管灌洗术及异物取出术治疗肺不张的疗效。方法回顾性分析我院呼吸科和耳鼻喉科通过胸部X线片及肺CT等影像学检查诊断为肺不张并行硬支气管镜检术的120例患儿临床资料,分析小儿肺不张的病因,评价支气管灌洗术及异物取出术治疗肺不张的疗效。结果气道阻塞性肺不张共117例,其中气管外源性异物87例(72.5%),内源性异物30例(25.0%),肺先天性发育不良3例(2.5%);经支气管灌洗术及异物取出术治疗,外源性异物造成的肺不张1周内复张总有效率97.7%,内源性异物造成的肺不张1周内复张总有效率63.3%,先天性肺发育不良3例均无效。结论小儿肺不张的病因主要为支气管阻塞;硬支气管灌洗术及异物取出术是治疗小儿肺不张的有效方法。

Application rigid bronchoscope to treatment atelectasis in children

Objective To investigate the reasons of atelectasis in children with rigid bronchoscope,and to evaluate the therapeutic effect of bronchial lavaging and removal of tracheobronchial foreign bodies.Methods Retrospective the clinical materials of 120 children in department of respiratory and otolaryngology,which were diagnosed atelectasis withⅩray or CT examination.All children were performed with rigid bronchoscope examination.The reasons of atelectasis were analyzed, and the therapeutic effect of bronchial lavaging and removal of tracheobronchial foreign bodies was evaluated.Results Totally 117 cases with atelectasis were caused with airway obstruction,and 87（72.5%） of them were caused by exogenous foreign bodies,30（25.0%）of them were caused by endogenous foreign body,3（2.5%） were caused by congenital dysplasia of lung.After performed bronchial lavaging and removal of tracheobronchial foreign bodies,97.7%of exogenous foreign bodies were removed,and the total effectiveness ration of endogenous foreign bodies was 63.3%,while no obviously effect in congenital dysplasia of lung.Conclusion It demonstrated that the airway obstruction was the main reason of atelectasis in children, and bronchial lavaging and removal of tracheobronchial foreign bodies was the effective treatment method.