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目的探讨无痛纤维支气管镜对喘息性疾病的诊断价值,以提高对喘息性疾病的病因诊断率。方法对在本院住院的喘息≥4周或1 a内因反复喘息≥3次、年龄为2个月～14岁经常规治疗无效或效果欠佳的54例患儿进行无痛纤维支气管镜检查,并将检查结果与临床资料进行对比分析,总结喘息性疾病的病因。结果直视镜下支气管内膜感染15例(占28.0%),6个月以上各年龄段均有分布;支气管异物13例,其中>1～3岁8例;气管支气管软化9例,其中6个月以内7例;呼吸道狭窄9例,其中右耳廓畸形合并气管下段狭窄1例,鸡胸、多指畸形合并右气管狭窄及弯曲畸形1例;呼吸道畸形5例;支气管内膜结核、声门下乳头状瘤、声门部血管瘤各1例。结论对于喘息性疾病患儿在常规治疗欠佳的情况下,应尽早进行纤维支气管镜检查,以排除支气管先天畸形、异物、肿瘤等,避免误诊。
Objective To investigate the diagnostic value of painless fiberoptic bronchoscopy in wheezing diseases to improve the diagnosis of wheezing diseases. Methods 54 cases of wheezing hospitalized in our hospital for ≥4 weeks or within 1 year because of recurrent wheezing ≥ 3 times, aged 2 months to 14 years of conventional treatment ineffective or ineffective, painless fiberoptic bronchoscopy, And the test results and clinical data were analyzed, summarize the etiology of wheezing diseases. Results Fifteen patients (28.0%) had bronchial intima infection under direct vision and all age groups were over 6 months. Thirteen cases of bronchial foreign bodies were found, of which 8 cases were> 1-3 years old. Among them, 9 Months in 7 cases; respiratory stenosis in 9 cases, of which the right auricle deformity with tracheal stenosis in 1 case, chicken chest, multi-finger deformity with right tracheal stenosis and flexion deformity in 1 case; respiratory malformations in 5 cases; bronchial tuberculosis, subglottic Papilloma, glottic hemangiomas in 1 case. Conclusions For children with wheezing diseases, in the case of poor routine treatment, bronchoscopy should be carried out as soon as possible to exclude congenital malformations of bronchus, foreign body and tumor, so as to avoid misdiagnosis.