Author/Editor     Kopriva, Silvester; Borinc-Beden, Andreja; Maček, Vasilija; Šorli, Jurij
Title     Bronhoskopije pri otrocih
Translated title     Bronchoscopy in children
Type     članek
Source     Endoskopska revija
Vol. and No.     Letnik 7, št. 18
Publication year     2002
Volume     str. 12-8
Language     slo
Abstract     Flexible broncoscopy (FB) in children began to gain ground much later than in adults. The main reason was that size-appropriate bronchoscopic allowing for a safe of FB in infants and children were developed much later and that clear-cut indications for this diagnostic procedure in children were not yet established. Before 1980, only rigid broncoscopes had been used in children, mostly for removal of foreign bodies. The advent of pediatric FB, however, enchanced the diagnostic applications of airway endoscopy in children. FB has proved a very useful tool for exploring airways and identifying the causes of obstruction in children, which in addition to acute and chronic inflammations, may be due to a variety of congenital and acquired airway abnormalities, or inhalation of a foreign body. Since the introduction of this technique in 1990, 1,052 bronchhoscopies and 47 bronchographies and 219 biopsies using flexible bronchoscope have been performed at this Department. The most common indication in our patients was airway obstruction of unknown origin. Also, FB was used to determine the etiology of chronic or recurrent lower airway inflammation and respiratory infections in children with congenital or acquired immunodeficient conditions. This paper presents in detail indications for FB in 35 children with bronchopulmonary dysplasia, discusses the advantages of FB over rigid bronchoscopy and vice versa, describes the preparation and sedation of children undergoing FB, and outlines the associated complications.
Summary     Bronhoskopija (BSK) z upogljivim (fiber) bronhoskopom (FB) se je pri otrocih pričela uveljavljati precej kasneje kot pri odraslih. Prvi razlog za to je bil, da ni bilo primerno majhnih inštrumentov za varno uporabo pri majhnih otrocih, drugi pa, da za tak poseg sprva ni bilo jasnih indikacij. Do začetka 80. let so pri otrocih v glavnem uporabljali le togi bronhoskop za odstranjevanje tujkov. Diagnostične možnosti te preiskave pa so se pričele razkrivati, ko so bili na voljo za otroke primerni FB. Pri otroku je BSK posebno uporabna v diagnosticiranju vzrokov obstrukcije v dihalnih poteh (ODP). Poleg akutnih ali kroničnih vnetij za ODP obstajajo še številni drugi vzroki, kot so prirojene in pridobljene nepravilnosti dihalnih poti ali aspiracije tujka, kar se s FB sve lahko neposredno vidi. Od leta 1990, odkar to preiskavo izvajamo na Pediatrični kliniki, smo napravili 1052 BSK in s pomočjo FB 47 bronhografij ter 219 biopsij. Tudi med našimi bolniki so bili za BSK daleč najpogostejša indikacija nepojasnjeni znaki ODP. Na drugem mestu pa nam je bila BSK v pomoč pri ugotavljanju etiologije kroničnih ali ponavljajočih se vnetij s spodnjih dihalnih in okužb dihal pri otrocih v stanjih s prirojeno ali pridobljeno zmanjšano odpornostjo. V članku podrobneje opisujemo indikacije za BSK pri 35 otrocih z bronhopulmonalno displazijo. Omenjamo še prednost preiskave s FB glede na BSK s togim bronhoskopom in obratno, pripravo in sediranjem otroka za BSK ter zaplete.
Descriptors     BRONCHOSCOPY
FIBER OPTICS
LUNG DISEASES
AIRWAY OBSTRUCTION
CHILD