胃管内灌注美兰支气管镜观察法对儿童先天性气管食管瘘诊断价值分析

发布时间：2018-05-23 19:44

本文选题：气管食管瘘 + 美兰　；参考：《中国实用儿科杂志》2017年03期

【摘要】：目的回顾性分析胃管内灌注美兰支气管镜观察法在儿童先天性气管食管瘘中的诊断价值。方法回顾性分析2015年9月至2016年5月深圳市儿童医院呼吸科确诊的2例先天性H型气管食管瘘患儿和3例先天性气管食管瘘术后复发患儿的临床资料,对食管造影、支气管镜常规检查法、管内灌注美兰支气管镜观察法、胸部CT的检查结果进行分析。结果 5例患儿胃管内灌注美兰后支气管镜检查均可观察到气管内美兰渗出;2例气管食管瘘术后复发患儿支气管镜常规检查未发现有瘘口存在;4例患儿行食管造影检查,仅1例诊断出气管食管瘘;4例患儿行胸部多排螺旋CT(MDCT)检查均未见到瘘管,但可见食管下段含气影。结论胃管内灌注美兰支气管镜观察法是诊断儿童先天性H型气管食管瘘和先天性气管食管瘘术后复发值得推荐的检查方法;常规支气管镜检查及食管碘油造影均有漏诊可能;胸部MDCT对于诊断先天性气管食管瘘价值有限,但食管下段含气影提示有气管食管瘘存在的可能。
[Abstract]:Objective to retrospectively analyze the diagnostic value of endogastric methylene blue bronchoscopy in children with congenital tracheoesophageal fistula. Methods the clinical data of 2 children with congenital H type tracheoesophageal fistula and 3 children with recurrent congenital tracheoesophageal fistula diagnosed by respiratory department of Shenzhen Children's Hospital from September 2015 to May 2016 were retrospectively analyzed. The results of routine bronchoscopy, endobronchial instillation of methylene blue bronchoscope and chest CT were analyzed. Results bronchial endoscopy in 5 children with intragastric methylene blue injection could be observed in 2 patients with recurrent tracheoesophageal fistula after tracheobronchial instillation. No fistula was found in 4 cases. Only one case of tracheoesophageal fistula was diagnosed as tracheoesophageal fistula in 4 cases. No fistula was found in the chest of 4 children with multiple spiral CTMDCT, but the lower esophagus could be seen with gas shadow. Conclusion the method of endobronchial instillation of methylene bronchoscope is a recommended method for the diagnosis of congenital H type tracheoesophageal fistula and congenital tracheoesophageal fistula in children. Chest MDCT is of limited value in the diagnosis of congenital tracheoesophageal fistula.
【作者单位】：深圳市儿童医院呼吸科;
【分类号】：R726.5

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