纤维支气管镜在小儿气管支气管软化症诊断中的价值

目的探讨纤维支气管镜对小儿气管支气管软化症的诊断作用。方法对335例常规诊治无明显好转的持续喘息或慢性咳喘患儿行纤维支气管镜（纤支镜）检查，观察气管支气管内腔变化，并对有感染灶者行纤支镜局部治疗。结果335例中诊断气管支气管软化症62例（占18．5％），气管软化17例，主支气管软化27例，叶支气管软化15例，段支气管软化3例；气管支气管软化合并喉软化7例；62例中原发性软化症59例，继发性软化症3例。62例中有52例（83．9％）在行纤支镜检查前被误诊。结论气管支气管软化症是引起小儿持续喘息或慢性咳喘的常见病因之一，临床容易误诊，纤维支气管镜是目前诊断气管支气管软化症的金指标。

Study on tracheobronchomalacia in children by flexible bronchoscopy

Objectives To explore the role of flexible bronchoscopy in diagnosing tracheobronchomalacia in chil -dren. Methods Clinical data and flexible bronchoscopy of 335 children with persistent wheezing or intractable cough from December 2002 to June 2006 were retrospectively analyzed. Results Tracheobronchomalacia was diagnosed in 62 out of a total of 335 patients, in which 17 cases were tracheomalacia, 27 cases were tracheobronchomalacia and 18 cases were bronchomalacia. Primary tracheobronchomalacia was identified in 59 cases while the other 3 were secondary tracheobronchomalacia characterized with extrinsic compression of the trachea. Of the 62 patients, 7 were laryngomalacia, 53 tra-cheosteosis. Fifty-two (52) of the 62 had been mistakenly diagnosed as infantile asthma, reactive airway disease before flexible bronchoscopy. Conclusions Tracheobronchomalacia is one of the reasons causing wheezing or chronic cough in children. Flexible bronchoscopy can be regarded as a golden criteria for diagnosis of tracheobronchomalacia.