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目的 探讨气管支气管软化症的临床特征及发病情况。方法 对常规诊治无明显好转的持续喘鸣及慢性反复咳嗽患儿应用纤维支气管镜 (纤支镜 )检查 ,观察气管支气管内腔变化 ,并对镜下有感染灶者行纤支镜局部治疗。结果 诊断气管支气管软化症 6 0例 ,其中总气管软化症 35例 ,总支气管软化症 2 4例 ,支气管软化症 1例。在原发性气管支气管软化症 5 2例中 ,3例曾于新生儿期经历食管闭锁手术 ,2例伴有气管瘘 ,4例伴有胃食管反流 ;8例继发性气管支气管软化症均有管外压迫。 6 0例患儿中镜下发现喉软化 10例 (16 7% ) ,气管粘膜炎性狭窄、肉芽及化脓等炎症表现 5 0例 (83 3% ) ;经X线 ,肺CT等检查证实合并肺感染 38例 (6 3 3% )。结论 气管支气管软化症是引起小儿经常咳喘的病因之一 ,纤支镜是目前诊断气管支气管软化症的金指标。
Objective To investigate the clinical characteristics and incidence of tracheobronchial softening disease. Methods The patients with persistent wheezing and chronic recurrent cough who had no obvious improvement in the routine diagnosis and treatment were examined with fiberoptic bronchoscopy to observe the change of tracheal bronchus lumen and the local treatment of bronchoscopy under the microscope. Results Sixty cases of tracheobronchoma were diagnosed, including 35 cases of total tracheal softening, 24 cases of total bronchofibrosis and 1 case of bronchofibrosis. Of the 52 patients with primary tracheobronchoma, 3 had esophageal atresia in the neonatal period, 2 had tracheal fistulas, 4 had gastroesophageal reflux, and 8 had secondary bronchoconstriction Have tube pressure. Sixty cases were found to have laryngopharyngeal softening in 10 cases (16.7%), inflammatory tracheal mucosa stenosis, granuloma and purulence in 50 cases (83.3%). X-ray, pulmonary CT and other tests confirmed the merger 38 cases of lung infection (63.3%). Conclusions Tracheal bronchoconstriction is one of the causes of recurrent cough and asthma in children. Bronchofibroscopy is the gold index for the diagnosis of tracheal bronchoconstriction.