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目的 探讨纤维支气管镜在小儿难治性肺炎肺不张诊断和治疗中的价值,为临床诊治提供参考.方法 选取2016年湖北省妇幼保健院收治的经保守治疗1周以上无效的肺炎肺不张患儿52例为研究对象,行纤维支气镜诊断和治疗,总结其镜下特点,完善诊断并评估疗效.结果 52例患儿纤维支气管镜镜下表现: 单纯支气管内膜炎15例 (28.85％),支气管化脓症8例 (15.38％),塑形支气管炎6例 (11.54％),黏膜苍白3例 (5.77％),异物3例 (5.77％),气管软化5例 (9.62％),支气管外压狭窄4例 (7.69％),支气管先天狭窄3例 (5.77％),气管性支气管3例 (5.77％),气管新生物1例 (1.92％),干酪样坏死1例 (1.92％).其中,纤维支气管镜检查中发现5例患儿非单纯性肺炎肺不张,纤维支气管镜修正诊断率9.62％,21例患儿有合并症,补充诊断40.38％.纤维支气管镜术后2周复诊疗效: 治愈率69.23％,好转率26.92％.结论 小儿难治性肺炎肺不张需考虑肺炎外其他因素,包括异物,结核,新生物,气管发育等因素,纤维支气管镜对于明确诊断,清除病灶,改善预后.“,”Objective To explore the value of fiber bronchoscope in diagnosis and treatment of children with refractory pneumonia and pulmonary atelectasis,provide a reference for clinical diagnosis and treatment. Methods In 2016,52 children with pneumonia and pulmonary atelectasis failing in conservative treatment for more than one week in Hubei Maternal and Child Health Care Hospital were selected, then diagnosis and treatment via fiber bronchoscope were carried out,the characteristics under fiber bronchoscope were summarized,the diagnosis was perfected,and the curative effect was evaluated. Results The endotracheal performance of 52 children: 15 children with simple endobronchitis (28. 85％),8 children with bronchial suppuration (15. 38％),6 children with plastic bronchitis (11. 54％),3 children with pale mucosa (5. 77％),3 children with tracheal foreign body (5. 77％),5 children with tracheomalacia (9. 62％),4 children with bronchial stenosis caused by external pressure (7. 69％),3 children with congenital bronchial stenosis (5. 77％),3 children with tracheal bronchus (5. 77％),1 child with tracheal neoplasm (1. 92％),and 1 child with caseous necrosis (1. 92％). Fiber bronchoscopy found five children with non-simple pneumonia and pulmonary atelectasis,the corrected diagnostic rate of fiber bronchoscopy was 9. 62％,21 children were found with complications,the supplementary diagnostic rate was 40. 38％. The children were followed up at two weeks after surgery using fiber bronchoscopy,the cure rate and improvement rate were 69. 23％ and 26. 92％,respectively. Conclusion For the children with refractory pneumonia and pulmonary atelectasis,other factors excluding pneumonia should be considered,including foreign body,tuberculosis,neoplasm,tracheal development,and so on. Fiber bronchoscopy can obtain definite diagnosis,remove the lesions,and improve prognosis.