目的 探讨电子支气管镜在小儿肺不张、肺气肿诊治中的应用价值.方法 对31例肺不张、35例肺气肿患儿在局部黏膜麻醉下行电子支气管镜检查及支气管肺泡灌洗、吸引等治疗.结果 31例肺不张以炎症最多见,共24例,占77.4%,其次是气管软化、支气管畸形共5例,占16.2%,异物后肉芽肿1例,占3.2%. 35例肺气肿也以炎症占第1位,共22例占62.9%,其次病因为支气管异物7例占20.0%,支气管异物以幼儿多见,气管支气管软化5例占14.3%.肺不张、肺气肿中各有肿瘤1例.24例感染性炎症引起的肺不张,经支气管镜清理痰栓、支气管肺泡灌洗治疗后大多在1周内复张,复张率为79.2%(19/24).结论 儿童肺不张、肺气肿病因以炎症占第1位,其次为支气管异物、软化、气道畸形,肿瘤相对少见.%Objective To explore the value of electronic bronchoscopy for children with atelectasis and emphysema. Methods 31 cases with atelectasis and 35 with emphysema were examined and treated by electronic bronchoscopy and bronchoalveolar lavage. Results In 31 cases with atelectasis, 24 cases were caused by inflammation (77.4%), which was the most common cause, followed by tracheobronchomalacia and bronch deformity n=5;(16.2%). 1 case had granuloma and 1 had tumour. In 35 cases with emphysema, 22 cases were caused by inflammation (62.9%), which was the most common cause, followed by foreign body n=7;(20%), tracheobronchomalacia n=5;(14.3%). Foreign body was most commonly seen in children during 1～3 years. 1 case had tumour. 19 of 24 cases had infection-associated atelectasis, showing re-expansion and were treated by bronchoalveolar lavage. Conclusion Inflammation is the most common cause of atelectasis and emphysema in children, followed by foreign body, tracheobronchomalacia and bronch deformity. Electronic bronchoscopy is effective in the diagnosis and treatment of atelectasis and emphysema in children.
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