| 纤维支气管镜诊治新生儿肺不张24例临床分析 |
| 投稿时间：2011-06-10 修订日期：2011-06-20 点此下载全文 |
| 引用本文：马友凤,王惠丽,谢俊英.纤维支气管镜诊治新生儿肺不张24例临床分析[J].医学研究杂志,2012,41(3):157-159 |
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| 中文摘要:目的探讨纤维支气管镜在新生儿肺不张诊治中的应用价值。方法采用日本产OLYPUS BFXP40型纤维支气管镜（外径2.8mm，内径1.2mm） 对24例新生儿感染性肺不张、疑胎粪吸入综合征及乳汁吸入后引起的肺不张进行纤维支气管镜检查并行支气管灌洗治疗，术后进行灌洗液的病原学检查。结果24例肺不张患儿顺利完成32例次纤维支气管镜检查和治疗。15例肺炎肺不张患儿术中表现支气管内膜炎，气管支气管气道分泌物多或黏液栓阻塞，支气管肺泡灌洗液培养阳性10例，根据培养结果调整治疗后1周复查胸片均恢复正常，6例术前怀疑胎粪吸入综合征患儿，在纤支镜直视下给予支气管肺灌洗均有黄绿色黏液及黄色胎粪颗粒状物吸出，5例患儿临床症状明显改善，72h胸片恢复正常。3例乳汁吸入性肺炎吸出较多乳汁及白色黏液样分泌物经1次支气管肺泡灌洗后24h复查胸片肺不张均消失。本组的并发症主要为一过性低氧血症，灌洗后发热及声音嘶哑。 结论纤维支气管镜检查术在新生儿肺不张诊断和治疗中有很大的价值，是一项安全而重要的检查技术，值得推广。 |
| 中文关键词:纤维支气管镜 新生儿肺不张 |
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| Clinical Analysis of Fiberbronchoscope in Diagnosis and Treating of the Neonatal Atelectasis:24 Cases |
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| Abstract:ObjectiveTo discuss the application value of fiberbronchoscope in treatment and diagnosis of the neonatal atelectasis. MethodsUsing Olypus BFXP40 fiberbronchoscope made in Japan (OD:2.8mm, ID:1.2mm),we examined and did the bronchial lavage treatment for 24 cases of neonatal infectious atelectasis, atelectasis caused by tire dung inhaled syndrome or milk inhaled. We checked the etiology of lavage fluid. ResultsThe 24 patients completed 32 times endoscopy and treatment successfully. Fitty cases showed bronchial endometritis, more secretions in airway and bronchial tube and block of mucous plug. Ten cases had positive alveolar lavage fluid cultured. We adjusted the treatment according to the cultured, After a week, all the chest radiographs were back to normal. Six cases of tire dung inhaled syndrome had yellow-green mucus and yellow blocky womb dung particles extracted in the inspection, 5 of the 6 had a obvious clinical improvement and the chest radiographs were back to normal after 72 hours. Three cases of milk inhaled were absorbed more milk and white myxoid secretions. After bronchoaleolar lavaged 24h, a repeated chest radiograph showed the disappearance of atelectasis. The complication of this group mainly was transient hypoxia, fever after lavage and hoarseness. ConclusionFiberbronchoscope had a great value in the diagnosis and treatment of neonatal atelectasis. It is a safe and important inspection technology and was worth popularize. |
| keywords:Fiberbronchoscope Neonatal atelectasis |
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