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目的探讨纤维支气管镜在新生儿科的应用价值及安全性。方法选择2012年7月至2015年12月我院行纤维支气管镜检查的新生儿,分析其疾病特征,记录检查前、中、后经皮血氧饱和度(SpO_2)、心率、血压,检查前、检查后30 min血气分析,以及检查中发生的并发症情况。结果共检查42例患儿,完成44例次检查,检出呼吸道异常40次,呼吸道异常检出率为90.9%。其中喉软化22例,占52.4%;气管、支气管软化或狭窄19例,占45.2%,确诊气管食管瘘1例,检查吻合率为73.8%。SpO_2在检查前、中、后的变化差异有统计学意义(P<0.05)。检查过程中患儿SpO_2下降,与检查前比较差异有统计学意义[(0.80±0.15)比(0.95±0.04),P<0.05],检查后可恢复,与检查前比较差异无统计学意义[(0.94±0.02)比(0.95±0.04),P>0.05]。检查过程中6例患儿出现心率下降,停止操作并加压给氧后恢复正常,血压无明显变化,监测血气分析均正常,未出现肺出血、心力衰竭等严重并发症。结论纤维支气管镜在新生儿科的应用具有一定的安全性和诊断价值,可提高新生儿呼吸系统疾病的临床诊治水平。
Objective To investigate the value and safety of fibrobronchoscopy in neonatology. Methods From July 2012 to December 2015, newborns underwent fibrobronchoscopy from July 2012 to December 2015 were analyzed for their disease characteristics. SpO2, heart rate and blood pressure before, during and after the examination were recorded, , 30 minutes after the examination of blood gas analysis, and check the complications occurred. Results A total of 42 children were examined, 44 cases were checked, 40 cases of abnormal respiratory tract were detected, and the detection rate of respiratory abnormalities was 90.9%. Throat softening in 22 cases, accounting for 52.4%; tracheal, bronchiectasis or stenosis in 19 cases, accounting for 45.2%, diagnosed with tracheoesophageal fistula in 1 case, check the anastomosis rate was 73.8%. SpO_2 in the examination before, during and after the change was statistically significant (P <0.05). SpO_2 in children with decreased during the examination, compared with before the test was statistically significant (0.80 ± 0.15) (0.95 ± 0.04), P <0.05], after examination can be restored, with no significant difference between before and after the test [ (0.94 ± 0.02) vs (0.95 ± 0.04), P> 0.05]. During the examination, 6 children showed a decrease in heart rate. After stopping the operation and returning to normal pressure and oxygenation, there was no significant change in blood pressure. Blood gas analysis was normal and no serious complications such as pulmonary hemorrhage and heart failure occurred. Conclusion The application of fibrobronchoscopy in neonatology has certain safety and diagnostic value, which can improve the clinical diagnosis and treatment of neonatal respiratory diseases.