【摘要】 目的分析可弯曲支气管镜在儿童坏死性肺炎中的诊断及治疗应用,探讨其临床价值。方法收集2016年12月至2017年12月于吉林大学第一医院小儿呼吸二科确诊为坏死性肺炎的32例患儿的临床资料,回顾性分析其临床表现、实验室检查结果、胸部X线或肺部CT资料、可弯曲支气管镜检查结果等资料,结合发病特点、诊断、治疗及预后,重点分析可弯曲支气管镜应用于坏死性肺炎的优势。结果 32例坏死性肺炎患儿确诊平均时间为14.1 d。32例均行可弯曲支气管镜术及肺泡灌洗液术,肺泡灌洗液均呈浑浊的米汤样改变,对诊断坏死性肺炎有较高的灵敏度,肺泡灌洗液出现米汤样改变平均时间为6.7 d。结论可弯曲支气管镜是坏死性肺炎的重要诊断治疗方法,肺泡灌洗液呈米汤样改变对坏死性肺炎有早期预测意义。更多还原

【Abstract】 Objective To evaluate the diagnostic and therapeutic value of flexible bronchoscopy in children with necro?tizing pneumonia. Methods Clinical data of children diagnosed with necrotizing pneumonia in the Department of Pedi?atrics of the First Hospital of Jilin University from December 2016 to December 2017 were collected. The general clini?cal manifestations,laboratory examination results,chest X-ray or lung CT,flexible bronchoscope and other examinations of all the children were analyzed retrospectively. Based on the characteristics,diagnosis,treatment and prognosis,the ad?vantages of flexible bronchoscopy in this disease were analyzed. Results All the 32 cases were diagnosed as necrotizing pneumonia by imaging examination,with an average diagnosis time of 14.1 d. All 32 cases of children with necrotizing pneumonia received flexible bronchoscopy and alveolar lavage. The alveolar lavage in 32 cases presented turbidity mito?ta-like changes,which had high sensitivity in the diagnosis of necrotizing pneumonia. The average time for mitota-like changes in alveolar lavage was 6.7 days. Conclusion Flexible bronchoscopy is an important method in the diagnosis and treatment of necrotizing pneumonia,and the change of alveolar lavage fluid is a sensitive index for early prediction of necrotizing pneumonia.更多还原