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1.
Indian J Tuberc ; 68(4): 527-528, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34752324

RESUMO

A 26 year old female presented with complaints of high grade fever and cough for 10 days. Nasopharyngeal swab tested for COVID-19 RT-PCR at admission was negative. Clinical examination suggested a patch of bronchial breathing in left infrascapular region and bilateral diffuse rhonchi. Chest X-ray was suggestive of left lower zone consolidation. HRCT showed a large patch of consolidation with GGO along with a cavitary lesion involving left lower lobe. Sputum for RT-PCR COVID 19 was positive. Patient was managed as per covid-19 protocol, subsequently showing clinical and radiological improvement.


Assuntos
COVID-19/diagnóstico , Pulmão/diagnóstico por imagem , Escarro/virologia , Tomografia Computadorizada por Raios X/métodos , Adulto , Broncoscopia , Teste de Ácido Nucleico para COVID-19 , Teste para COVID-19 , Tosse/etiologia , Feminino , Febre/etiologia , Humanos , Radiografia , SARS-CoV-2
2.
J Coll Physicians Surg Pak ; 31(12): 1459-1467, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34794288

RESUMO

The effects of bronchoscopy and chest CT on early evaluation of patients with hemoptysis are still controversial. PubMed, EMBASE, and the Cochrane Library databases were systematically searched. Odds ratio (OR) was applied to assess the utility of bronchoscopy for hemoptysis etiology and site in comparison with CT in the various clinical processes. A total of 23 studies were included (N=4635). The results showed that bronchoscopy implied a lower overall diagnostic accuracy, especially in identifying the etiology of hemoptysis, compared with CT (OR= 0.34, 95% CI: [0.23, 0.51], OR=0.21, 95% CI: [0.14, 0.31], respectively). When the results of radiograph were normal, the effectiveness of bronchoscopy was significantly weaker than that of CT (OR=0.32, 95% CI: [0.22, 0.45]). In the cases of massive hemoptysis, bronchoscopy and CT had no statistical significance for identifying bleeding (OR=0.27, 95% CI: [0.02, 3.18]). The study suggested that bronchoscopy did not show superior diagnostic accuracy than CT for patients with hemoptysis at the first visit. Key Words: Hemoptysis, Bronchoscopy, CT, Meta-analysis.


Assuntos
Broncoscopia , Hemoptise , Bases de Dados Factuais , Hemoptise/diagnóstico por imagem , Hemoptise/etiologia , Humanos , Razão de Chances , Tomografia Computadorizada por Raios X
3.
Kyobu Geka ; 74(12): 1043-1046, 2021 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-34795151

RESUMO

We experienced a case of a foreign body in the lung with granuloma by aspiration of watermelon seeds. A 72-year-old woman who had been diagnosed as having lung foreign body was admitted to our hospital for the treatment of the pulmonary shadow caused by the granuloma. A foreign body could not be identified by bronchoscopy, and the thoracoscopic partial resection of right S4 was performed. The postoperative course was uneventful, and the patient was discharged from our hospital on the second day after the operation.


Assuntos
Citrullus , Corpos Estranhos , Neoplasias Pulmonares , Idoso , Broncoscopia , Humanos , Pulmão
4.
Artigo em Inglês | MEDLINE | ID: mdl-34767704

RESUMO

Successful bronchoscopic bronchopleural fistula closure requires both accurate localization of the fistula and device implantation; placing a silicone plug requires experience and skill because of the limited endobronchial working space. We report a novel bronchoscopic silicone plug placement technique for a bronchopleural fistula that developed after a left upper lobectomy following induction chemoradiation therapy, which was then successfully treated by omentopexy.


Assuntos
Fístula Brônquica , Doenças Pleurais , Fístula Brônquica/cirurgia , Broncoscopia , Cateterismo , Humanos , Doenças Pleurais/cirurgia , Silicones
5.
BMJ Case Rep ; 14(11)2021 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-34799393

RESUMO

Patients with SARS-CoV-2 pneumonia can suffer from pneumothorax and persistent air leak (PAL). The pneumothorax occurs with or without pre-existing lung disease. PAL refers to air leak lasting more than 5-7 days and arises due to bronchopleural or alveolopleural fistula. The management of PAL can be challenging as a standard management guideline is lacking. Here we present the case of a 42-year-old smoker with COVID-19 who presented to the hospital with fever, cough, acute left-sided chest pain and shortness of breath. He suffered from a large left-sided pneumothorax requiring immediate chest tube drainage. Unfortunately, the air leak persisted for 13 days before one-way endobronchial valve (EBV) was used with complete resolution of the air leak. We also review the literature regarding other cases of EBV utilisation for PAL in patients with COVID-19.


Assuntos
COVID-19 , Enfisema , Pneumotórax , Adulto , Broncoscopia , Humanos , Masculino , Pneumotórax/diagnóstico por imagem , Pneumotórax/etiologia , Pneumotórax/terapia , SARS-CoV-2
6.
Intern Med ; 60(21): 3463-3467, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34719627

RESUMO

Tracheobronchopathia osteochondroplastica (TPO) is a very rare, benign disorder involving the lumen of the trachea-bronchial tree. However, its etiology is unknown. In our first case, observation for several years showed that TPO worsened as interstitial lung disease was aggravated. In the second case, the lung parenchymal lesion on computed tomography (CT) was found to be compatible with interstitial lung abnormality (ILA). We believe that our cases suggest a common pathogenetic relationship between TPO and fibrotic interstitial lung disease. TGF-ß is likely a common factor in the pathogenesis of TPO and fibrotic interstitial lung disease.


Assuntos
Doenças Pulmonares Intersticiais , Osteocondrodisplasias , Doenças da Traqueia , Broncoscopia , Humanos , Doenças Pulmonares Intersticiais/diagnóstico por imagem , Osteocondrodisplasias/complicações , Osteocondrodisplasias/diagnóstico , Traqueia , Doenças da Traqueia/diagnóstico , Doenças da Traqueia/diagnóstico por imagem
7.
Zhongguo Dang Dai Er Ke Za Zhi ; 23(10): 981-986, 2021 Oct 15.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-34719411

RESUMO

OBJECTIVES: To study the safety and efficacy of dexmedetomidine hydrochloride combined with midazolam in fiberoptic bronchoscopy in children. METHODS: A total of 118 children who planned to undergo fiberoptic bronchoscopy from September 2018 to February 2021 were enrolled. They were divided into a control group (n=60) and an observation group (n=58) using a random number table. The observation group received intravenous pumping of dexmedetomidine hydrochloride (2 µg/mL) at 1 µg/kg and then intravenous injection of midazolam at 0.05 mg/kg, followed by dexmedetomidine hydrochloride pumped intravenously at 0.5-0.7 µg/(kg·h) 10 minutes later to maintain anesthesia. The control group was given intravenous pumping of propofol at 2 mg/kg and then intravenous injection of midazolam at 0.05 mg/kg, followed by propofol pumped intravenously at 4-6 mg/(kg·h) 10 minutes later to maintain anesthesia. Fiberoptic bronchoscopy was performed after the children were unconscious. Heart rate (HR), respiratory rate, blood oxygen saturation, and mean arterial pressure (MAP) were recorded before inserting the bronchoscope (T0), at the time of inserting the bronchoscope (T1), when the bronchoscope reached the glottis (T2), when the bronchoscope reached the carina (T3), and when the bronchoscope entered the bronchus (T4). The intraoperative peak airway pressure (Ppeak), examination time, degree of sedation, extent of amnesia, incidence of adverse reactions, postoperative awakening time, and postoperative agitation score were also recorded. RESULTS: Compared with the control group, the observation group had significantly decreased MAP at T1 to T4 and HR at T1 to T3 (P<0.05). Compared with that at T0, MAP was significantly increased at T1 to T4 in the control group and at T3 in the observation group (P<0.05). HR was significantly higher at T1 to T3 than at T0 (P<0.05). Compared with the control group, the observation group showed significantly lower intraoperative Ppeak value, incidence of intraoperative adverse reactions, and postoperative agitation score, significantly shorter examination time, and better effects of amnesia and anesthesia (P<0.05). There was no significant difference in the degree of intraoperative sedation and postoperative awakening time between the two groups (P>0.05). CONCLUSIONS: Dexmedetomidine hydrochloride combined with midazolam is a safe and effective way to administer general anesthesia for fiberoptic bronchoscopy in children, which can ensure stable vital signs during examination, reduce intraoperative adverse reactions and postoperative agitation, shorten examination time, and increase amnesic effect.


Assuntos
Dexmedetomidina , Midazolam , Brônquios , Broncoscopia , Criança , Dexmedetomidina/efeitos adversos , Humanos , Hipnóticos e Sedativos/efeitos adversos , Estudos Prospectivos
9.
Ann Palliat Med ; 10(9): 9889-9901, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34628915

RESUMO

BACKGROUND: A systematic review and meta-analysis were performed to explore the adoption value of electronic bronchoscopy (EBS) in the diagnosis and treatment of refractory pneumonia and to provide a theoretical basis for the clinical bronchoscopy treatment of patients. METHODS: Randomized controlled trials of treatment-resistant pneumonia searched on PubMed, Embase, and other websites before December 31, 2020 were collected. Literature was selected by inclusion and exclusion criteria. Bias risk was assessed using Cochrane intervention system Review manual 5.0.2 and Review Manager 5.3. RESULTS: A total of 6 articles meeting the requirements were included, comprising 796 participants. The results of meta-analysis showed that the clinical efficacy [odds ratio (OR) =3.8; 95% confidence interval (CI): 1.11-12.99; Z=2.13; P =0.03] and white blood cell counts [mean difference (MD) =0.55; 95% CI: -0.57 to 1.67; Z=0.96; P=0.34] of patients both increased. The mortality rate (OR =0.7; 95% CI: 0.3-1.63; Z=0.82; P=0.41), the incidence of infection (OR =0.84; 95% CI: 0.5-1.39; Z=0.69; P=0.49), ICU hospitalization days (OR =0.59; 95% CI: 0.36-0.98; Z=2.04; P=0.04), days of antibiotic use (OR =0.39; 95% CI: 0.18-0.84; Z=2.41; P=0.02), body temperature (MD =-0.2; 95% CI: -0.24 to 0.16; Z=9.5; P<0.0001), and the PaO2:FIO2 ratio (MD =-9.96; 95% CI: -13.31 to -6.61; Z=5.83; P<0.0001) of patients in the experimental group were lower than those of the control group. Differences in white blood cell count, mortality rate, and incidence of infection of patients in the experimental group were not statistically significant compared with those in the control group. DISCUSSION: EBS adopted in the diagnosis and treatment of refractory pneumonia can reduce the occurrence of postoperative adverse reactions, reduce the infection rate, and effectively improve the clinical symptoms. It is therefore suitable for the treatment of this disease.


Assuntos
Broncoscopia , Pneumonia , Eletrônica , Humanos , Tempo de Internação , Resultado do Tratamento
10.
J Coll Physicians Surg Pak ; 31(11): 1366-1368, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34689501

RESUMO

The radiological appearance of lung abscess is nonspecific and can masquerade as a mass lesion during the early phase. The treatment is primarily medical, but surgical treatment is necessary when the size is larger than 6 cm and when patients show any indications of massive hemoptysis, empyema, bronchial obstruction, and risk of cancer or when the medical treatment fails. A 55-year male patient presented with complaints of back pain over a period of two years with additional complaints such as fatigue and coughing up of blood. On physical examination, crackles in the right upper zone of his lungs were observed. Chest x-ray revealed a cavitary lesion in the right upper zone. The patient was taken to the hospital with preliminary diagnosis of lung cancer. A fiberoptic bronchoscopy (FOB) was performed resulting in a preliminary diagnosis of malignancy. No endobronchial lesion was detected in FOB. The bronchoalveolar lavage (BAL) culture was negative. The BAL cytology was also benign. As a result, oral levofloxacin treatment was started. During follow-up examination, a partial reduction in the size of cavity was observed. As a result of this observation, PET-CT was ordered. According to the results, 18F-fluorodeoxyglucose (FDG) uptake of the level (maximum standardised uptake value [SUVmax]: 10.9) suspicious for malignancy was noted in the right hilar lymph node associated with irregular lobulated mass, which was considered to be  associated with the pleura in the posterior segment of the right upper lobe.  The patient was taken for surgery in light of these findings. The pathological results were consistent with abscess. The patient has no complaints six months after the surgical operation. Key Words: Lung abscess, Cavitary lesion, Lung cancer, PET scan.


Assuntos
Abscesso Pulmonar , Neoplasias Pulmonares , Broncoscopia , Fluordesoxiglucose F18 , Humanos , Pulmão , Abscesso Pulmonar/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Masculino , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada
12.
Artigo em Inglês | MEDLINE | ID: mdl-34639674

RESUMO

Bronchoscopy is one of the basic invasive procedures in pulmonology accompanied by patients' anxiety. This study aimed to find an association between predictors of state anxiety/depression and patient's quality of life (QOL) with pulmonary symptoms undergoing diagnostic flexible video bronchoscopy (FVB). A total of 125 adult patients before FVB were included in a prospective observational study. The quality of life (QOL) was assessed by WHOQOL-BREF questionnaire, the depression possibility by the Beck's Depression Inventory-II (BDI-II), and the anxiety level by Spielberger's State-Trait Anxiety Inventory (STAI-S; STAI-T). Results show that the older patients and patients with more comorbidities showed a significantly higher anxiety level. The previous FVB under deep sedation significantly reduced state anxiety. A significantly positive association was found between the STAI score and total BDI-II score. More severe symptoms of anxiety were especially related to lower QOL (physical health, psychological and environmental domains) in patients. Statistically higher trait anxiety in lower social QOL domain scores was observed. Our findings show that high state and trait anxiety were associated with higher depression scores and lower quality of life in the elderly. It seems that the elderly and patients at risk of depression development require more attention in the clinical setting to minimize the anxiety accompanying the bronchoscopy.


Assuntos
Depressão , Qualidade de Vida , Adulto , Idoso , Ansiedade/epidemiologia , Transtornos de Ansiedade , Broncoscopia , Depressão/diagnóstico , Depressão/epidemiologia , Humanos
13.
J Med Case Rep ; 15(1): 533, 2021 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-34670611

RESUMO

INTRODUCTION: With early diagnosis, fiberoptic or rigid bronchoscopy methods are the gold standard in the management of tracheobronchial foreign body. Otherwise, nonrecognized bronchial foreign bodies cause irreversible damage to the airways and lungs. The deficiency of the health system noted in many developing countries such as Madagascar, combined with the fundamental problem relating to children's conditions, which are determined by social and educational factors, makes it almost impossible to provide early and appropriate management of the penetration syndrome. CASE PRESENTATION: An 11-year-old Malagasy female patient was referred to our hospital for an investigation of the etiology of the patient's hemoptysis. The investigations revealed a localized bronchiectasis and atelectasis due to a foreign body obstructing the left main bronchus. Based on the hemoptysis and left lung almost destroyed by an occlusive lesion within, we decided to proceed with left pneumonectomy. A retrospective interrogation revealed a choking episode 4 years prior in elementary school after the child sucked on a pen cap and involuntarily aspirated it. Two years after the pneumonectomy, our patient was doing well and was asymptomatic. CONCLUSION: In this case report, we describe a rare case of a late presentation of foreign body aspiration that resulted in a left pneumonectomy in a child. Despite our favorable results, pneumonectomy must be the preferred last option. Preventive actions remain the optimal approach.


Assuntos
Corpos Estranhos , Pneumonectomia , Brônquios/diagnóstico por imagem , Brônquios/cirurgia , Broncoscopia , Criança , Feminino , Corpos Estranhos/diagnóstico por imagem , Corpos Estranhos/cirurgia , Humanos , Estudos Retrospectivos
14.
Medicine (Baltimore) ; 100(43): e27620, 2021 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-34713848

RESUMO

RATIONALE: Pulmonary foreign body aspiration is a serious medical problem. The risk of foreign body aspiration into the airways increases considerably in patients with end stage cancer with reduced consciousness and impaired airway reflexes. However, few studies have reported on foreign body aspiration in the airways in patients with terminal cancer or receiving end-of-life care. Herein, we report the use of flexible bronchoscopy in patients with end-of-life cancer with pulmonary aspiration. PATIENT CONCERNS: A 71-year-old man with neuroendocrine carcinoma was admitted to a palliative care unit for end-of-life care. He accidentally aspirated implant teeth into the airway with decreased consciousness and death rattle. DIAGNOSIS: On chest x-ray, the foreign material was observed in the left main bronchus. INTERVENTIONS: Despite concerns regarding the use of bronchoscopy given the deterioration of the overall organ function, flexible bronchoscopy was performed. OUTCOMES: Eventually, the foreign body was removed using a basket in the nasal cavity without major complications. The patient died comfortably after 7 days. LESSONS: The possibility of patients in the palliative care unit with reduced consciousness and death rattle to aspirate foreign bodies into the airways must be carefully considered. Flexible bronchoscopy should be considered to carefully remove aspirated foreign bodies in the airway without any side effects, even in patients with terminal cancer or receiving end-of-life care.


Assuntos
Broncoscopia/métodos , Corpos Estranhos , Aspiração Respiratória/cirurgia , Idoso , Carcinoma Neuroendócrino/patologia , Humanos , Masculino , Testes de Estado Mental e Demência , Cuidados Paliativos/métodos , Neoplasias Gástricas/patologia , Assistência Terminal/métodos
16.
Int J Chron Obstruct Pulmon Dis ; 16: 2809-2815, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34675505

RESUMO

Background: Lung volume reduction with endobronchial coils treatment (ECT), for patients with severe emphysema, has shown modest improvement in exercise capacity and lung functions in clinical trials, yet the benefit of this procedure is still unclear. Methods: We conducted a multicenter retrospective cohort study including all patients who underwent ECT in Israel and a propensity score matched control group of patients with chronic obstructive pulmonary disease (COPD) that were treated with usual care. The primary outcome was six-minute walk test distance (6MWTD), secondary outcomes were lung function tests and patient survival. Results: Overall, 46 patients were included in the ECT group. Their mean 6MWTD at baseline and at 6 and at 24 months post procedure was 331.0±101.4, 372.9±76.8 and 338.8±104.8, respectively (overall P=0.04, pairwise comparison: baseline to 6 months (P=0.1), baseline to 24 months (P=1.0)). Mean FEV1 values at baseline and at 6 and at 24 months post procedure were 0.86±0.38, 0.92±0.37 and 0.82±0.36 liters, respectively (overall P=0.003, pairwise comparison: baseline to 6 months (P=0.04), baseline to 24 months (P=0.75)). The median 6MWTD for the ECT and control groups at 24 months were 333.0 (262.5-390) and 280 (210-405), respectively (P=0.16). There was no difference in overall survival (P=0.84). Heterogenous emphysema was a significant predictor of treatment success in univariate analysis (p=0.004). Conclusion: Lung volume reduction with endobronchial coils may improve the exercise capacity and FEV1 of COPD patients. However, the majority of the effect was diminished after 24 months. The current state of evidence does not support regulatory approval of ECT and warrant its use only after consideration of the benefit-harm ratio in a highly selected patient population.


Assuntos
Enfisema , Doença Pulmonar Obstrutiva Crônica , Enfisema Pulmonar , Broncoscopia , Tolerância ao Exercício , Volume Expiratório Forçado , Humanos , Pulmão , Pneumonectomia , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/terapia , Enfisema Pulmonar/cirurgia , Enfisema Pulmonar/terapia , Estudos Retrospectivos , Resultado do Tratamento
17.
PLoS One ; 16(10): e0258972, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34710141

RESUMO

INTRODUCTION: Ultrasound-guided tracheostomy (UGT) and bronchoscope-guided tracheostomy (BGT) have been well compared. However, the differences in benefits between UGT and landmark tracheostomy (LT) have not been addressed and, in particular, lack a detailed meta-analysis. We aimed to compare the first-pass success, complication rate, major bleeding rate, and tracheostomy procedure time between UGT and LT. METHODS: In a systematic review, relevant databases were searched for studies comparing UGT with LT in intubated patients. The primary outcome was the odds ratio (OR) of first-pass success. The secondary outcomes were the OR of complications, OR of major bleeding, and standardized mean difference (SMD) of the total tracheostomy procedure time. RESULTS: The meta-analysis included three randomized controlled studies (RCTs) and one nonrandomized controlled study (NRS), comprising 474 patients in total. Compared with LT, UGT increased first-pass success (OR: 4.287; 95% confidence interval [CI]: 2.308 to 7.964) and decreased complications (OR: 0.422; 95% CI: 0.249 to 0.718). However, compared with LT, UGT did not significantly reduce major bleeding (OR: 0.374; 95% CI: 0.112 to 1.251) or the total tracheostomy placement time (SMD: -0.335; 95% CI: -0.842 to 0.172). CONCLUSIONS: Compared with LT, real-time UGT increases first-pass success and decreases complications. However, UGT was not associated with a significant reduction in the major bleeding rate. The total tracheostomy placement time comparison between UGI and LT was inconclusive.


Assuntos
Broncoscopia/métodos , Traqueostomia/métodos , Ultrassonografia de Intervenção/métodos , Pontos de Referência Anatômicos , Broncoscopia/efeitos adversos , Humanos , Cooperação Internacional , Complicações Pós-Operatórias/etiologia , Traqueostomia/efeitos adversos , Ultrassonografia de Intervenção/efeitos adversos
18.
Thorac Surg Clin ; 31(4): 417-427, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34696854

RESUMO

Early diagnosis in lung cancer is desirable, because surgical resection offers the only hope of cure. In the face of suggestive symptoms, a normal plain chest radiograph does not exclude the diagnosis, and investigation is essential. The various imaging changes seen on computerized tomography and PET scan provide strong suggestive evidence of lung cancer, but proof of diagnosis rests on histologic examination, material that may be obtained by one of the following diagnostic procedures: bronchoscopy, mediastinoscopy, fine needle aspiration biopsy, thoracentesis and pleural biopsy, lymph node biopsy, and exploratory thoracotomy.


Assuntos
Neoplasias Pulmonares , Broncoscopia , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/terapia , Mediastinoscopia , Estadiamento de Neoplasias , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X
19.
Thorac Surg Clin ; 31(4): 469-476, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34696859

RESUMO

Pulmonary neuroendocrine tumors (NETs) are relatively rare; however, their incidence is steadily increasing. They now comprise 1% to 2% of all lung cancers. Lung NETs are classified based on the World Health Organization classification into low-, intermediate-, and high-grade tumors. Most patients present with nonspecific symptoms that can result in delayed diagnosis. Bronchoscopy and biopsy are essential to diagnose and classify pulmonary NETs. Surgery is the mainstay of therapy and R0 resection is key. Lung preservation surgery, whenever possible, is preferred. There is little role of systemic therapy in NETs. Survival after R0 resection is reasonably good especially in low-grade tumors.


Assuntos
Tumor Carcinoide , Neoplasias Pulmonares , Tumores Neuroendócrinos , Broncoscopia , Humanos , Pulmão , Neoplasias Pulmonares/diagnóstico , Tumores Neuroendócrinos/diagnóstico , Tumores Neuroendócrinos/cirurgia
20.
Zhonghua Er Ke Za Zhi ; 59(11): 963-967, 2021 Nov 02.
Artigo em Chinês | MEDLINE | ID: mdl-34711032

RESUMO

Objective: To explore the clinical utility of bronchoscopy and transbronchial cryotherapy in children with tracheobronchial tuberculosis (TBTB). Methods: Retrospective study was conducted to collect the clinical data of 10 hospitalized children who underwent bronchoscopy and were diagnosed as TBTB and in the Department of Pediatrics of Peking University First Hospital and the Department of Pediatric Respiratory Medicine of the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University from January 2011 to October 2019. The clinical characteristics of TBTB in children, and the efficacy and safety of bronchoscopy and transbronchial cryotherapy were summarized through descriptive analysis. Results: The onset age of 10 children (6 males and 4 females) ranged from 1-14 years. The clinical manifestations included fever (8/10), cough (7/10) and hemoptysis (2/10). Purified protein derivative test and interferon-γ release assay were performed in 9 and 10 patients respectively, the results were all positive. Chest CT examination was performed in all patients, and 8 patients had hilar and mediastinal lymphadenopathy. All patients underwent pediatric bronchoscopy in time, in 9 patients bronchus was found to be blocked in varying degrees by granulation tissue and caseous necrosis and in the remaining patient, obvious congestion and edema in bronchial mucosa. The bronchoscopic manifestations included 8 cases of lymph node fistula type, 1 case of granulation proliferative type and 1 case of inflammatory infiltration type. Pathological biopsies were performed in 7 cases, the findings were consistent with the pathological characteristics of tuberculosis. Nine patients were treated by pediatric bronchoscopic intervention, with 8 transbronchial cryotherapy by flexible bronchoscopy, and among them, 2 patients were treated by simultaneous rigid bronchoscopy. After 1-3 times of transbronchial cryotherapy, the blocked bronchial lumina in 8 cases were all recanalized, and the curative effect was significant without any serious complications. Conclusions: Bronchoscopy plays an important role in the diagnosis of TBTB in children and is helpful for its classification. Also, transbronchial cryotherapy has good efficacy and safety for TBTB in children, especially for the granuloproliferative type or lymph node fistula type.


Assuntos
Tuberculose , Adolescente , Brônquios , Broncoscopia , Criança , Pré-Escolar , Crioterapia , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos , Tuberculose/diagnóstico , Tuberculose/terapia
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