摘要
目的 探讨儿童支气管异物的临床表现,提高诊断水平和总结最佳手术方式.方法 回顾性分析本院2013年8月至2017年8月行支气管镜诊断和治疗的105例支气管异物患儿的临床资料、异物种类、异物滞留部位、支气管镜下表现、影像学特征及治疗效果.结果 儿童支气管异物好发于男童（男∶女为2.5∶1）,主要发病年龄为1～3岁（66.67％）,患儿居住地农村多于城市（城市36.19％,农村63.81％）,尤以农村男童为高发人群.吸入异物种类以可食性异物为主,以植物类多见,占68.57％.支气管异物滞留于左、右主支气管的比例差别明显,滞留于右侧支气管病例数明显多于左侧,占60.00％.异物在支气管镜下表现为管腔粘膜充血、水肿,异物滞留在气道的不同部位所引起的临床症状有区别,最常见症状为咳嗽和喘息.影像学中胸部CT结果提示气管支气管异物是65例,阳性率为61.90％.异物存留时间大于5d者均有不同程度的肉芽增生.全部均行支气管镜尝试取异物,手术方式以球囊和异物网篮拖拉取出为主.结论 支气管异物以农村3岁以下的男童多见,加强宣教,使监护人认识到植物类食物对3岁以下儿童的危害性,减少婴幼儿对植物类食物的接触.对于有反复咳嗽、喘息病史的患儿,详细询问异物吸入史或呛咳史,建议行胸部CT的同时,积极行支气管镜检查防止误诊、漏诊.在手术方式的选择上,可尝试采用球囊拽取异物的新方式.
Objective To explore the clinical manifestations of children＇s bronchial foreign body, and improve the diagnostic level and sum up the best surgical method. Methods The clinical data, foreign bodies, types, foreign body retention area, manifestations under the bronchoscope, imaging characteristics, and therapeutic effect of 105 children with bronchial foreign bodies diagosed and treated with bronchoscope at our hospital from August, 2013 to August, 2017 were retropectively analyzed. Results More male got bronchial foreign bodies than female in the children （2.5： 1）. 66.67% of the children were 1 to 3 years old. 63.81% of the children were from rural areas and 36.19% city; the rural boys were high-risk group. The intake of foreign species were mainly edible foreign bodies, with the majority of plants, accounting for 68.57%. 60.00% bronchial foreign bodies located in right main bronchus. Bronchoscope showed that the main manifestations were lumen mucosa congestion and edema. The foreign bodies stuck in the different parts of airway caused different clinical symptoms, commonly cough and wheezing. The results of chest CT indicated that 65 cases had bronchial foreign bodies, with a positive rate of 61.90%. The ones with foreign objects over 5 days had different degrees of granulation growth. All the children＇s foreign bodies were extracted by bronchoscopy. The main surgical methods were mainly using balloon and foreign body net. Conclusions Bronchial foreign body mainly occurs in under 3 years old boy in rural areas. Strengthening propaganda and education, making the guardians realize the danger of plant foods to under 3 years old children, reducing infant exposure to plant foods, inquiring the histories of intaking foreign bodies and choking in children with histories of recurrent cough and puffing, recommendation for chest CT, and actively taking bronchoscopic examination can prevent misdiagnosis and missed dignosis. In the selection of surgical methods, a new method of collecting foreign objects i
作者
黄冬平
黄苑铭
谢丹宇
黎静
唐远平
陈运彬
彭淑梅
Huang Dongping;Huang Yuanming;Xie Danyu;Li Jing;Tang Yuanping;Chen Yunbing;Peng Shumei(Department of Pediatrics at Yuexiu, Guangdong Maternal and Child Health Care Hospital, Guangzhou 510010, China)
出处
《国际医药卫生导报》
2018年第10期1471-1474,共4页
International Medicine and Health Guidance News
关键词
气管支气管异物
儿童
临床分析
支气管镜
Tracheobronchial foreign body
Children
Clinical analysis
Bronchoscopy
