Bronchoscopy in the diagnosis and treatment of children with bronchiectasis / 中华实用儿科临床杂志

ABSTRACT

Objective To analyze the clinical features and the application of bronchoscopy in diagnosis and treatment of children with bronchiectasis.Methods All cases with bronchiectasis were collected from in-patient department of the Children's Hospital Affiliated to Nanjing Medical University from December 2011 to November 2015.Clinical manifestations,results of bronchoscopy examination were retrospectively analyzed.Results Of the 33 children,32 cases (97.0％) had chronic cough and sputum.Lung infection was the main cause (50％,16/33 cases).High resolution CT showed signet ring sign and/or double-track sign in lungs,and bronchiectatic lesions were most commonly found in the lower lobes (60.6％).Eighteen cases underwent bronchoscope ciliary biopsy,and the number of cilia decrease was found in 2 cases,and cilia ultrastructure abnormalities were found in 6 cases,with 2 cases diagnosed as Kartagener syndrome.The treatment included the followingtreatment of the underlying disease,aggressive treatment of infections,promotion of mucociliary clearance,and bronchoscopy.The symptoms of the most patients were relieved through the symptomatic treatment.Follow-ups after discharge,showed that 15 cases had a slight cough without obvious sputum,11 cases with recurrent lung infections,regular bronchoscope lavage treatment;4 cases underwent surgical lung resection and recovered well postoperative,and 2 cases died.Conclusion The bronchoscopy should be performed early in the children with bronchiectasis,which can clearly detect pathogens and causes,so as to undertake lavage treatment to improve clinical symptoms.