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目的评估纤维支气管镜在早产极低体重儿呼吸道疾病诊治中的价值和安全性。方法选择16例患有呼吸道疾病的早产极低体重儿予以局部麻醉、面罩加压手控供氧下行纤维支气管镜检查和治疗。结果 16例患儿除外1例双肺弥漫出血家属放弃抢救死亡,余15例均治愈出院。9例肺不张患儿经治疗24 h后5例复张,4例未完全复张患儿再次进行第2次支气管镜吸引后于术后48~72 h均复张。无BPD发生。结论纤维支气管镜检查和治疗对早产极低体重儿呼吸系统疾病能明显缩短肺不张、肺炎等疾病的病程,有助于减少BPD的发生。只要做好充分的术前准备,术中采用局部麻醉和间断面罩手控皮囊供氧的方式,早产新生儿的纤维支气管镜检查和治疗是安全、有效的。
Objective To assess the value and safety of fiberoptic bronchoscopy in the diagnosis and treatment of respiratory diseases in preterm low birth weight infants. Methods Sixteen cases of preterm low birth weight infants with respiratory diseases were selected for local anesthesia. The face mask was manually ventilated by hand under the control of fiberoptic bronchoscopy. Results Except one case of 16 children with diffuse hemorrhage of lungs, their relatives gave up rescuing and more than 15 cases were cured. Nine cases of atelectasis in children after treatment of 24 h after the 5 cases of re-expansion, 4 cases of incomplete re-expansion of children again after the second bronchoscopy suction 48-72 h postoperative recovery. No BPD occurred. Conclusion Fiberoptic bronchoscopy and treatment of preterm low birth weight infants with respiratory diseases can significantly shorten the duration of atelectasis, pneumonia and other diseases, help to reduce the incidence of BPD. As long as adequate preoperative preparation, intraoperative use of local anesthesia and intermittent manual oxygen mask way, premature neonatal bronchoscopy and treatment is safe and effective.