[Clinical analysis of bronchial foreign bodies in 246 children].

OBJECTIVE: To analyze the characters of bronchial foreign bodies in children and the utilization of bronchoscope in the treatment of bronchial foreign bodies. METHODS: A total of 246 children were diagnosed with bronchial foreign bodies at our hospital during January 2000 until August 2009. Under local mucosal anesthesia, a bronchoscope was inserted through nasal cavity into bronchi. After identifying the site of foreign body, grasping forceps was guided through bronchoscope to remove the foreign body from airway. RESULTS: Among 246 cases, hard nut and skin of melon seed were found (n = 230, 93.5%). The most common site of foreign body was in right lower lobe bronchi (n = 98, 38.9%). The average operative frequency was 1.9 +/- 1.3 and one-time extraction ratio 58.5% (n = 144). The one-time extraction ratio of patients with foreign body obstructed in main bronchi (91.1%), right middle lobe (60.0%) and right lower lobe (55.1%) was higher than others. The operation frequency of using basket grasping forceps (1.4 +/- 0.9) was lower than those using tooth type forceps (2.1 +/- 1.4). And the difference was significant (P = 0.000). CONCLUSION: For bronchial foreign body in pediatric patients, hard nut and skin of melon seed are the most common foreign bodies. The right and left lower lobe bronchi are the predilection site. Foreign body in main bronchus is the easiest to be removed by grasping forceps. For massive foreign bodies, basket grasping forceps fares better than tooth grasping forceps.

[Measurement of pulmonary function with body plethysmograph in infants].

OBJECTIVE: To observe the alterations of pulmonary function in infants with respiratory diseases. METHODS: A total of 900 infants with respiratory diseases were recruited and pulmonary function measured in 30 healthy infants. The tests were performed in the sleeping infants with sedation. Tidal breathing flow-volume (TBFV) loops were recorded when infants were breathing quietly. Passive flow-volume technique was used to obtain static respiratory system compliance and resistance. Functional residual capacity was measured by body plethysmograph. RESULTS: The TBFV loop showed proximate round or oval curve in healthy infants. The shape and parameters of TBFV loop had significant differences in infants with respiratory diseases as compared with healthy controls. The TBFV loop displayed a concave expiratory curve and ratio of time to reach tidal peak flow to total expiratory time, the expiratory volume till peak flow divided by the total expiratory volume significantly decreased in infants with small airway obstruction. The expiratory or inspiratory curve showed a plateau and the ratio of mid-expiratory to mid-inspiratory flow was less than 60% or over 150% in infants with upper airway obstruction. The TBFV loop turned narrow and lung volume decreased in infants with restrictive diseases. CONCLUSION: The TBFV loop show proximate round or oval curve in healthy infants. Pulmonary function has significant differences between healthy controls and infants with respiratory diseases. Pulmonary function test is useful in the assessment of respiratory diseases.

[Role of flexible bronchoscopy in the treatment of infection-associated atelectasis in children].

OBJECTIVE: Infection-associated atelectasis is rather common during childhood and the effects of drug therapy are often unsatisfactory. The present study aimed to evaluate the effectiveness of flexible bronchoscopy in the treatment of infection-associated atelectasis in children. METHODS: One hundred and twenty-five patients (68 male and 57 female; age ranged from 10 d to 14 years and their courses of disease were from 3 d to 2.5 years) with infection-associated atelectasis confirmed by chest X-ray or CT were enrolled in the study. The following conditions were excluded by bronchoscopy: airway foreign body, airway anomalies, tumor, tuberculosis. The patients were divided into two groups: flexible bronchoscopy group and medication group. In the flexible bronchoscopy group, 65 patients were treated mainly with flexible bronchoscopy whereas in medication 60 group patients only received medication. Chest X-ray or CT was regularly reviewed for every patient, meanwhile the effect of flexible bronchoscopy at different courses of disease was observed. RESULTS: Flexible bronchoscopy group and medication group had no significant differences in age, sex and course of disease (P > 0.05). In flexible bronchoscopy group 39 patients were cured, 20 were improved and 6 cases had no change; in medication group 17 patients were cured, 25 were improved and 18 had no change. The two groups had significant differences (P < 0.01); in bronchoscopy group there were significant differences among patients with the courses of disease less than 3 months, 3 to 6 months and more than 6 months. CONCLUSIONS: The authors concluded that flexible bronchoscopy was an effective method for treatment of infection-associated atelectasis. Flexible bronchoscopy can reach pathological part and clear pus and granulation. It can remove obstruction and relieve symptoms. When course of disease was short, bronchoscopic therapy was advantageous to recovery of atelectasis. Bronchial washing may overcome the shortcomings of bronchoalveolar lavage, therefore the former seemed to be more suitable for treatment of infection-associated atelectasis.