纤维支气管镜在撤机失败新生儿中的应用
孟燕妮;陈艳萍;李秀龙
【期刊名称】《中国小儿急救医学》 【年(卷),期】2016(000)001
【摘要】Objective To evaluate the safety and efficacy of fiberoptic bronchoscopy in the diagno-sis of 41 neonates with weaning failure.Methods A retrospective study on the results of fiberoptic broncho-scopy was performed in 41 neonates with weaning failure.Results A total of 41 neonates of throat abnor-malities were examined by fiberoptic bronchoscopy,including 38 cases with laryngomalacia,8 cases with seri-ous hyperemia and swelling of the vocal cords,2 cases with scar stenosis of subglottic,and one case in each of congenital laryngeal web,glottic insufficiency and congenital epiglottis cyst;trachea-bronchial abnormali-ties,including 31 cases with tracheomalacia,2 cases with tracheal stenosis,4 cases with partial bronchial ste-nosis,1 cases with bridging bronchus and 1 cases with tracheoesophageal fistula.Thirty-eight neonates under-went fiberoptic bronchoscopy
to
obtain
bronchoalveolar
lavage
fluid
and
culture,bacterial culture positive in 15 cases(39.4%),of which 5 cases of Klebsiella pneumoniae,3 cases in each of Pseudomonas aeruginosa and Acinetobacter baumannii,2 cases of Staphylococcus aureus,1 case in each of Escherichia coli and Strep-tococcus mitis;fungal culture positive
for 6 cases(15.7%),of which 3 cases of Aspergillus fumigatus,1 case in each of Candida glabrata,Candida albicans and Candida parapsilosis.The most common complications of fiberoptic bronchoscopy were hypoxia and heart rate transient decline(26 cases,63.4%),3 cases fever af-ter operation.Conclusion Fiberoptic bronchoscopy can not only find congenital tracheal deformity and tra-cheal mucosa lesions,but also complete the etiology from deep discharge.Fiberbronchoscopy is safe and relia-ble given adequate preparation and if it is performed by skilled personnel.%目的：对我院因撤机失败的41例新生儿行纤维支气管镜(纤支镜)检查,以积极寻求原发疾病及探讨其安全性。方法回顾性分析我院新生儿科收治的41例因撤机失败行纤支镜检查患儿的资料。结果41例新生儿经纤支镜检查发现,咽喉部异常包括喉软骨软化38例,声带严重充血肿胀8例,声门下不规则瘢痕形成2例,先天性喉蹼、声门闭合不全、会厌囊肿各1例；气管-支气管异常包括气管软化31例,气管狭窄2例,局部支气管段狭窄4例,支气管桥、气管食管瘘各1例。38例患儿行纤支镜获取肺泡灌洗液并送培养,细菌培养阳性15例(39.4%),其中肺炎克雷白杆菌5例,铜绿假单胞菌、鲍曼不动杆菌各3例,金黄色葡萄球菌2例,大肠埃希菌、缓症链球菌各1例；真菌培养阳性6例(15.7%),其中烟曲霉菌3例,光滑假丝酵母菌、白假丝酵母菌和近平滑假丝酵母菌各1例。纤支镜检查最常见的并发症是低氧血症、心率一过性下降(26例,63.4%),3例患儿出现术后发热。结论纤支管镜检查不但可以发现先天性呼吸道畸形,还能了解气管黏膜的病变情况,并能留取深部分泌物完善病原学检查,只要给予充分准备,支气管镜由操作熟练人员进行,纤支镜术安全可靠。
【总页数】4页(41-44)
【关键词】新生儿;撤机失败;纤维支气管镜;机械通气 【作者】孟燕妮;陈艳萍;李秀龙
【作者单位】410007 长沙，湖南省儿童医院呼吸二科;410007 长沙，湖南省儿童医院呼吸二科;410007 长沙，湖南省儿童医院呼吸二科 【正文语种】中文 【中图分类】 【文献来源】
https://www.zhangqiaokeyan.com/academic-journal-cn_chinese-pediatric-emergency-medicine_thesis/0201235701173.html 【相关文献】
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2.纤维支气管镜在新生儿困难气管插管中的应用 [J], 陈卓毅; 林创兴 3.纤维支气管镜在新生儿领域的应用进展 [J], 张谦慎; 朱小瑜 4.纤维支气管镜在新生儿呼吸疾病临床诊断中的应用价值 [J], 李宏云 5.新生儿纤维支气管镜在NICU中的应用 [C], 何少茹
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纤维支气管镜在撤机失败新生儿中的应用
