本文選題：氣管食管瘺 + 美蘭��； 參考：《中國(guó)實(shí)用兒科雜志》2017年03期

【摘要】：目的回顧性分析胃管內(nèi)灌注美蘭支氣管鏡觀察法在兒童先天性氣管食管瘺中的診斷價(jià)值。方法回顧性分析2015年9月至2016年5月深圳市兒童醫(yī)院呼吸科確診的2例先天性H型氣管食管瘺患兒和3例先天性氣管食管瘺術(shù)后復(fù)發(fā)患兒的臨床資料,對(duì)食管造影、支氣管鏡常規(guī)檢查法、管內(nèi)灌注美蘭支氣管鏡觀察法、胸部CT的檢查結(jié)果進(jìn)行分析。結(jié)果 5例患兒胃管內(nèi)灌注美蘭后支氣管鏡檢查均可觀察到氣管內(nèi)美蘭滲出;2例氣管食管瘺術(shù)后復(fù)發(fā)患兒支氣管鏡常規(guī)檢查未發(fā)現(xiàn)有瘺口存在;4例患兒行食管造影檢查,僅1例診斷出氣管食管瘺;4例患兒行胸部多排螺旋CT(MDCT)檢查均未見(jiàn)到瘺管,但可見(jiàn)食管下段含氣影。結(jié)論胃管內(nèi)灌注美蘭支氣管鏡觀察法是診斷兒童先天性H型氣管食管瘺和先天性氣管食管瘺術(shù)后復(fù)發(fā)值得推薦的檢查方法;常規(guī)支氣管鏡檢查及食管碘油造影均有漏診可能;胸部MDCT對(duì)于診斷先天性氣管食管瘺價(jià)值有限,但食管下段含氣影提示有氣管食管瘺存在的可能。
[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.
【作者單位】： 深圳市兒童醫(yī)院呼吸科;
【分類號(hào)】：R726.5

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