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首页> 外文期刊>Archives of disease in childhood >Safety and ethics of bronchoscopy and endobronchial biopsy in difficult asthma.
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Safety and ethics of bronchoscopy and endobronchial biopsy in difficult asthma.

机译：困难哮喘患者的支气管镜检查和支气管内活检的安全性和伦理学。

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AIM: To investigate the safety of bronchoscopy and endobronchial biopsy in children with difficult asthma, and discuss the ethical issues associated with the procedure. METHODS: A three year prospective observational study was performed in two tertiary paediatric respiratory centres specialising in the management of children with difficult asthma. A total of 48 children with difficult asthma and 35 non-asthmatic children were studied. RESULTS: Flexible bronchoscopy was performed under general anaesthesia in 38 children with difficult asthma, and rigid bronchoscopy was performed in 10, following a two week course of prednisolone. Endobronchial biopsy was performed in 47 patients. Perioperative complications occurred in one asthmatic undergoing flexible bronchoscopy (desaturation) and in two undergoing rigid bronchoscopy (desaturation in one, and bronchospasm and desaturation in one). There were no cases of significant bleeding or pneumothorax among the asthmatics. Flexible bronchoscopy was performed in 35 non-asthmatic patients with a variety of clinical indications. The total number of perioperative complications was greater in the non-asthmatics undergoing flexible bronchoscopy than in the asthmatics (17 complications in 35 children versus one in 38). Fever requiring hospital admission was documented in two asthmatics following bronchoscopy. Four asthmatics reported an increase in symptoms in the week following bronchoscopy. CONCLUSIONS: Bronchoscopy and endobronchial biopsy under general anaesthesia can be performed safely in children with difficult asthma, when the bronchoscopist and anaesthetist are suitably trained. The procedure is acceptable to the families involved.
机译：目的：探讨困难哮喘儿童的支气管镜检查和支气管内活检的安全性，并讨论与该手术相关的伦理问题。方法：在两个专门治疗儿童哮喘的三级小儿呼吸中心进行了为期三年的前瞻性观察研究。总共对48名患有哮喘的儿童和35名非哮喘儿童进行了研究。结果：38例困难哮喘患儿在全身麻醉下进行了柔性支气管镜检查，在泼尼松龙治疗2周后，在10例中进行了刚性支气管镜检查。 47例患者进行了支气管内活检。围手术期并发症发生在一例接受柔性支气管镜检查（去饱和）的哮喘患者中，以及二例接受刚性支气管镜检查（一者进行去饱和，一例进行支气管痉挛和去饱和）的哮喘患者。哮喘患者中无大出血或气胸病例。在35例具有各种临床适应症的非哮喘患者中进行了柔性支气管镜检查。接受软支气管镜检查的非哮喘患者围手术期并发症的总发生率高于哮喘患者（35例儿童中的17例，38例中的1例）。支气管镜检查后的两名哮喘患者中记录了需要入院的热病。四名哮喘患者在支气管镜检查后一周内症状有所增加。结论：经适当的支气管镜和麻醉师培训，哮喘较困难的儿童可以安全地进行全身麻醉下的支气管镜检查和支气管内活检。所涉家庭可以接受该程序。

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