Clinical Application Of Fiberoptic Bronchoscopy In Diagnosis And Treatment Of Children Pneumonia Under Local Anesthesia

Pneumonia is a common respiratory disease in children. Pediatric respiratoryinfection morbidity and mortality was significantly higher than adult, because of theirpediatric respiratory anatomical and physiological characteristics and immunecharacteristics. The severity of the clinical symptoms varying widely, is still one ofthe important diseases that threaten the healthy development of children.2000-2003World Health Organization statistics shows that: Pneumonia is the first cause of deathin children under5years old, its mortality19%, and incidence of children pneumoniain developed countries is0.05times/person-years. The incidence of childrenpneumonia in developing countries is six times of developed countries. There are160million emerging children pneumonia annually in the world. Of which about150million cases of children in developing countries. most patients needs hospitaltreatment. However, due to the replacement of the pathogen, resistant bacteriageneration, different individual sensitivity to drugs and individual differences inchildren. Approximately2.4million children die each year because of pneumonia.inshort, caused by multiple pathogens of pneumonia in children is still a threat tochildren’s health and life. In recent years, fiberoptic bronchoscopy (bronchoscopy) arewidely used in the diagnosis and treatment of pediatric respiratory diseases, provide astrong basis for the diagnosis and treatment of pediatric respiratory disease, especiallyfor the treatment of refractory pneumonia. ObjectiveDiscussion fiberoptic bronchoscope under local anesthesia (bronchoscopy)clinical value in the treatment of pneumonia in children.Thereby improving thediagnosis and treatment of pediatric pneumonia and broaden the scope of applicationof bronchoscopy.MethodsCollected and analyze the clinical data of136cases of pneumonia in childrenwith in the treatment of local anesthesia bronchoscopy in the Third Affiliated Hospitalof Zhengzhou University from August2011to May2013.Systematic retrospectiveanalysis from a gender, age, clinical manifestations, signs and symptoms, laboratoryfindings, imaging findings, treatment, treatment effects.Result136cases of children under local anesthesia bronchoscopy and lavagetreatment,of which76males and60females：21cases of1to6months,6months to1year in25cases,39cases of1to3years,3to7years in36cases,15cases of7to14years old.CT chest：lesions involving the lungs in58cases, lesions involving the leftlung in35cases,lesions involving the right lung in43cases; pulmonary effusion in82cases,54cases of consolidation; pleural effusion in37cases,20cases ofatelectasis.Laboratory tests:49cases of abnormal ESR,30cases of elevated liverenzymes,78cases of elevated cardiac enzymes.The number of peripheral bloodleukocytes:less than4×109/L in16cases,（4-10）×109/L in48cases,（10-20）×109/L in52cases, more than20×109/L cases.Bronchoscopy results：136cases of lunginfection(100%), Congenital bronchopulmonary dysplasia14cases(10.2%),7casesof bronchial foreign body(5.1%).52cases of bacterial culture positive lavage（38.2%）,Sputum culture was positive in36cases (26.5%).Lavage fluid culturepositive rate was higher than that of sputum culture.117cases of the child pneumoniaby bronchoscopy lavage symptoms improved rapidly, the cure rate was86%.7casesof tracheal foreign bodies diagnosed by fiberoptic bronchoscopy. Conclusion1．The treatment of bronchoscopy lavage for children with pneumonia under thecondition of local anesthesia is simple, safe and effective.2．Bronchoscopy for the diagnosis and treatment of pediatric respiratory diseaseshave a certain value...