| Objection:Forty-five neonates with respiratory symptoms were diagnosed and analyzed.The clinical characteristics of children with congenital respiratory structure and dysfunction and the diagnostic and therapeutic effects of flexible bronchoscopy were explored.Methords:A total of 45 newborns who were admitted to the First Hospital of Jilin University from January 2017 to July 2019.They had respiratory symptoms and met the bronchoscopy indications.A total of 45 newborns who had bronchoscopy after parental consent were selected.Forty-five cases,with the consent of the family members,a 2.8mm outer diameter bronchoscope(Olimpus,BF-XP260)was used to sequentially observe the children's nasal cavity,pharyngeal cavity,epiglottis,glottis,trachea,carina,main bronchi,and each leaf and segment bronchus.The situation can be treated under the endoscope at the same time.Results:1?According to the bronchoscopy indications,the main reasons for bronchoscopy in this group of newborns are as follows: neonatal signs:17 cases of throat soreness,7 cases of dyspnea,5 cases of persistent nasal congestion,4 cases of difficulty in weaning,and placement of gastric tubes There were 4 cases of failure,3 cases of oral and nasal secretions,2cases of tracheal intubation difficulty,2 cases of hoarseness,and 1 case of pneumonia.2?Results of bronchoscopy examination: In this group of 45 children with bronchoscopy,different types of respiratory tract structures or functional abnormalities were detected in a total of 43 cases,the positive rate was 95.56%,and the remaining 2 cases were suggestive of inflammation.Among 43 cases of abnormal airway structure or function,different types of abnormalities were: laryngeal softening in 8 cases,nasal stenosis in 6 cases,vocal cord paralysis in 4 cases,tracheoesophageal fistula in 4cases,tracheobronchial softening in 3 cases,and tracheal stenosis in 3cases.Pharyngeal cavity was softened in 3 cases,glottic insufficiency in3 cases,posterior ring area swelling in 3 cases,subglottic stenosis in 2cases,glottic fissure stenosis in 2 cases,epiglottic insufficiency in 2 cases,epiglottic insufficiency in 1 case,and epiglottic cyst in 1 case.There were1 case of tongue root cyst,1 case of nasal cerebrospinal fluid bulging,1case of cleft palate movement weakened,1 case of fall of tongue base,1case of larynx.There were 34 cases of single airway structural or dysfunction.Themost common cases were: nasal stenosis in 6 cases,laryngeal softening in5 cases,tracheoesophageal fistula in 4 cases,tracheobronchial softening in 1 case,tracheal stenosis in 2 cases,and glottic stricture in 2 There were2 cases of paralysis of vocal cords,2 cases of swelling in the posterior region of the ring,and 2 cases of insufficiency of glottis.9 cases of mixed respiratory structure or function abnormalities:laryngeal softening combined with glottic insufficiency,laryngeal softening combined with tracheal softening,laryngeal softening combined with swelling in the posterior ring zone,tracheal stenosis combined with subglottic stenosis,tracheal softening combined with vocal cord paralysis,and posterior pharyngeal cavity softened Nasal and meningeal bulge,posterior pharyngeal cavity softening combined with epiglottic insufficiency,posterior pharyngeal cavity combined with epiglottic movement limitation,subglottic stenosis and vocal cord paralysis were in 1 case each.Of the 43 children with abnormal airway structure or function,there were 12 cases with extra-respiratory abnormalities: tracheal softening combined with ventricular septal defect;bronchial softening combined with congenital cleft palate,congenital valgus foot,funnel chest;laryngeal softening with gastroesophageal reaction Flow;laryngeal softening,swelling of the posterior annulus with gastroesophageal reflux,congenital renal dysplasia;laryngeal softening with congenitalhypertrophic pyloric stenosis;tracheoesophageal fistula with congenital esophageal atresia,atrial septal defect;tracheoesophageal fistula with congenital Esophageal atresia,six-finger deformity;tracheoesophageal fistula combined with congenital esophageal atresia,atrial septal defect,and ventricular septal defect;epiglottic activity is restricted with congenital abnormalities(special appearance);posterior fall of the tongue with mandibular deformity,cleft palate,external ear auricles Malformation,considered as Pierre Robin syndrome;bilateral nasal stenosis with labial hemangioma;posterior ring swelling with six-finger malformation in each case.3.Related treatment cases after clearing the cause through bronchoscopy: 43 children were diagnosed with structural or functional abnormalities of the respiratory tract under the microscope,and 7 cases were treated accordingly.Two cases of tracheoesophageal fistula combined with congenital esophageal atresia were treated with esophageal anastomosis and esophageal tracheal fistula repair,1 case with severe trachea softening and silicone stent placement,1 case with tracheal stenosis and silicone stent placement,and 1 case with tongue root cyst Holmium laser tongue root cyst ablation and epiglotoplasty were performed,1 case of meningocele was repaired by meningocele,and 1case of laryngopharynx was treated by microscopic anterior separation.One child with tracheal stenosis and subglottic stenosis diedafter giving up treatment,and the remaining 35 patients with abnormal airway structure or function were discharged from the hospital after treatment.Conclusion:1.Congenital abnormalities in the structure or function of the respiratory tract have a higher detection rate in newborns.2.For neonates with unexplained dyspnea and larynx,bronchoscopy should be actively performed to further determine whether there are congenital abnormalities in the structure or function of the respiratory tract.3.Not only can Bronchoscopy be used to diagnose diseases in newborns,but also to assist with treatment. |
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