纤维支气管镜在新生儿重症监护室的应用分析

目的 探讨纤维支气管镜在新生儿重症监护室(neonatal intensive care unit,NICU)中的应用指征和安全性。方法 回顾性分析2012年1月至2014年5月在上海市儿童医院NICU住院的35例患儿的纤维支气管镜检查结果及相关临床资料。结果 35例患儿中,31例存在不同程度的气道畸形。20例进行支气管肺泡灌洗液培养,其中14例与痰培养或气管插管尖端培养结果一致。23例患儿在纤维支气管镜检查前后进行影像学检查,16例提示肺部炎症改善。28例好转出院,2例死亡,5例放弃治疗出院。21例在纤维支气管镜检查前后查血气分析提示差异无统计学意义,31例检查后查血常规提示C-反应蛋白下降。结论 纤维支气管镜检对新生儿某些疾病具有诊断和治疗的双重价值,在NICU中应用相对安全。
Objective To investigate the indications,safety and values of fiberoptic bronchoscopy in neonatal intensive care unit (NICU). Methods Retrospectively analyse the clinical data of 35 cases of fiberoptic bronchoscopy in NICU of Shanghai Children′s Hospital from Jan., 2012 to May, 2014. Results Among the 35 cases of fiberoptic bronchoscopy, 31 cases had various degrees of airway abnormal. Fourteen cases of 20 cases who underwent bronchoalveolar lavage got the same bacterial culture results between the bronchoalveolar lavage fluid culture and the sputum culture or endotracheal intubation culture. The pneumonia were improved in 16 cases of 23 cases who had radiography tests before and after bronchoscopy. Among the 35 cases, 28 cases were discharged from hospital, 2 cases died,and the outcomes were not available in the other 5 cases who withdrawn from treatments. The blood gas analysis had no significant difference in 21 cases before and after bronchoscopy. C-reactive protein was decreased in 31 cases after broncoscopy. Conclusions Fiberoptic bronchoscopy is valuable both in diagnosis and treatments, and it is relatively safe in NICU.