Morphological diagnosis of pediatric flexible bronchoscopy in pediatric intensive care unit
10.3969/j.issn.1008-9691.2024.01.012
- VernacularTitle:儿童重症监护病房可弯曲支气管镜下形态学诊断分析
- Author:
Haidong WANG
1
;
Zhuanhuan DU
;
Weina PEI
;
E'ying CAO
;
Jing WU
Author Information
1. 兰州大学第二医院儿童重症医学科,甘肃兰州 730030
- Keywords:
Flexible bronchoscopy;
Pediatric intensive care unit;
Diagnosis;
Pediatric
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2024;31(1):58-62
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical application value of pediatric electronic bronchoscopy on the diagnosis of respiratory disease in the pediatric intensive care unit(PICU)by morphological diagnosis.Methods The clinical data of 124 patients with PICU respiratory critically ill patients who underwent bedside electronic bronchoscopy from July 2017 to December 2022 in Lanzhou University Second Hospital were retrospectively analyzed.Pathogen examination of 96 cases of bronchoalveolar lavage fluid(BALF),bronchoscopy guided nasal endotracheal intubation in 3 cases was conducted.The accuracy of diagnosis of lung lesions was compared between electronic bronchoscopy and chest CT,and the morphological changes of lung lesions under electronic bronchoscopy were observed.Results The accuracy of electronic bronchoscopy in the diagnosis of tracheoesophageal fistula,tracheoesophageal rupture and bronchial foreign body is significantly higher than that of chest CT(tracheoesophageal fistula:4 cases vs.0 case,tracheoesophageal rupture:4 cases vs.0 case,bronchial foreign body:4 cases vs.6 cases,all P<0.05),and there was no significant difference in the accuracy of diagnosis of lung contusion and bronchiectasis between electronic bronchoscopy and chest CT.Typical cases confirmed under endoscopic:4 cases(3.23%)had tracheoesophageal fistula.Bronchial rupture 4 cases(3.23%).Endobronchial tuberculosis was diagnosed in 1 case(0.81%)with bronchial neoplasms and white caseous material attached to the mucosa.Positive bacteria were detected in 23 cases(23.96%).Guided nasotracheal intubation was performed in 3 children with jaw or cervical fracture.Endotracheal catheterization under mechanical ventilation was performed in 13 cases.There were no serious complications and death during and after the operation.Conclusion Pediatric bendable bronchoscopy with PICU is safe and reliable.It can improve the diagnosis rate of respiratory diseases in PICU,and has high clinical application value.
