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目的探讨婴幼儿呼吸道发育畸形的临床特点和诊断方法。方法从2007年1月~2011年2月本院儿科在耳鼻喉科协助下采用pentaxFB-8V型或pentaxFB-15V型纤维支气管镜在静脉复合麻醉下对112例因反复咳嗽、气喘、反复肺炎,治疗效果差而住院的患儿行支气管镜检查。对呼吸道发育畸形的35例进行临床分析。结果呼吸道发育畸形患儿35例,占检查患儿总数的31.2%,以1岁内婴儿多见;临床表现为反复咳嗽、喘息,反复肺炎、哮喘。常规X线胸片、胸部CT,不能提供确诊依据,临床治疗效果差。发现呼吸道软化20例,呼吸道狭窄8例,气管性支气管3例,气管支气管开口异常2例,气管食管瘘1例,气管憩室1例。结论婴幼儿呼吸道发育畸形临床表现及影像学检查缺乏特异性,常易误诊,赖于纤维支气管镜检查确诊。
Objective To investigate the clinical features and diagnosis of respiratory and malformation in infants and young children. METHODS: From January 2007 to February 2011, pediatric patients undergoing general anesthesia with pentaxFB-8V or pentaxFB-15V bronchoscopy assisted with otolaryngology were enrolled in this study. One hundred and twelve patients with repeated cough, asthma, recurrent pneumonia, Poor treatment and hospitalized children underwent bronchoscopy. 35 cases of deformity of respiratory tract were analyzed. Results 35 cases of respiratory malformations children, accounting for 31.2% of the total number of children examined, more common in infants aged 1 year; clinical manifestations of repeated coughing, wheezing, repeated pneumonia, asthma. Routine X-ray, chest CT, can not provide a diagnosis based on the clinical treatment of poor results. 20 cases of respiratory tract softening, 8 cases of respiratory tract stenosis, 3 cases of tracheal bronchus, 2 cases of tracheobronchial anomalies, 1 case of tracheal esophageal fistula and 1 case of tracheal diverticulum were found. Conclusion The clinical manifestation and imaging examination of respiratory and malformation in infants and young children lacks specificity and is often misdiagnosed, depending on the diagnosis of bronchoscopy.