The Clinical Application Analysis Of Flexible Bronchoscopy In Diagnosis And Treatment Of Children With Chronic Cough

Objective To explore the clinic value and safety of flexible bronchoscopy in diagnosis and treatment children with chronic cough.Methods 125 cases of ill children with chronic cough and needed to further complete the inspection of flexible bronchoscopy from May 2017 to September 2018 in the department 2 of respiration of Anhui children’s hospital were chosen.Retrospectively analyzed the result of flexible bronchoscopy and lavage fluid along with their clinical manifestation,the course of diagnosis and treatment.Results Of the 125 cases,73 cases were male(58.4%),52 cases were female(41.6%);92 cases were under 6 years old and more common(73.6%);32 cases were finally diagnosed as cough variant asthma(25.6%),27 cases as post infectious cough(21.6%),22 cases as upper airway cough syndrome(17.6%),18 cases as congenital respiratory diseases(14.4%),12 cases as protracted bacterial bronchitis(9.6%),9 cases as bronchial foreign body(7.2%),3 cases as atopic cough(2.4%),1 case as esophago-tracheal fistula(0.8%),1 case as endobronchial tuberculosis(0.8%).Of the 125 bronchoalveolar lavage fluid pathogenic culture cases,12 cases were positive(9.6%),5 cases were streptococcus pneumoniae(4.0%),3 cases were hemophilus influenza(2.4%),2 cases were hemolytic streptococcus(1.6%),1 case was pseudomonas aeruginosa(0.8%),1 case was staphylococcus aureus(0.8%).Of the 125 lavage fluid mycoplasma pneumoniae DNA test cases,38 cases were positive(30.4%).8 cases were removed the foreign body successfully by the bronchoscope,1 case was transferred to the department of ENT and then removed under general anesthesia because of hyoxemia and intolerance.There were 7 intraoperative complications of flexible bronchoscopy cases(5.6%),bronchial or nasal bleeding 2 cases(1.6%),transient decrease in oxygen saturation 4 cases(3.2%),convulsion 1 case(0.8%).There were 12 postoperative complications cases(9.6%),fever 6 cases(4.8%),aggravation of cough 4 cases(3.2%),bloody sputum 2 cases(1.6%).Conclusion The causes of chronic cough in children are complex and have individual differences,the causes of cough in different age children are obvious different.Cough variant asthma,post infections cough,upper airway cough syndrome are the main causes of chronic cough in children.Mycoplasma pneumoniae,cytomegalovirus,streptococcus pneumoniae,hemophilus influenza are the main pathogen of chronic cough.The inspection of flexible bronchoscopy plays an important role in diagnosis and treatment of Children with Chronic Cough,especially has obvious advantages in diagnosis of children congenital respiratory diseases,diagnosis of protracted bacterial bronchitis and its etiological examination,removal of sputum and mucus plug in bronchi,discovery and removal of bronchial foreign body.Flexible bronchoscopy is a relatively safe and effective method of diagnosis and treatment.