山东大学耳鼻喉眼学报 ›› 2015, Vol. 29 ›› Issue (6): 39-42.doi: 10.6040/j.issn.1673-3770.0.2015.303

• 论著 • 上一篇    下一篇

小儿气管支气管异物2000例

高滢1, 王正辉1, 常会敏2, 吴彩芹1, 寇晓会1, 许珉1   

  1. 1. 西安交通大学第二附属医院耳鼻咽喉头颈外科, 陕西 西安 710004;
    2. 西安医学院第一附属医院耳鼻喉科, 陕西 西安 710013
  • 收稿日期:2015-07-20 出版日期:2015-12-16 发布日期:2015-12-16
  • 通讯作者: 吴彩芹. E-mail:caiqinwu11@163.com E-mail:caiqinwu11@163.com
  • 作者简介:高滢. E-mail:quail_0_0@163.com

Foreign bodies in children's bronchus: an analysis of 2000 cases

GAO Ying1, WANG Zhenghui1, CHANG Huimin2, WU Caiqin1, KOU Xiaohui1, XU Min1   

  1. 1. Department of Otolaryngology & Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi, China;
    2. Department of Otolaryngology, The First Affiliated Hospital of Xi'an Medical University, Xi'an 710013, Shaanxi, China
  • Received:2015-07-20 Online:2015-12-16 Published:2015-12-16

PDF (PC)

506

摘要： 目的 探讨小儿气管支气管异物的临床特点、诊断处理经验及预防措施.方法 回顾分析小儿气管支气管异物患者2 000例的病历资料,总结小儿气管支气管异物患者的发病年龄分布、就诊情况、常见异物种类、发生部位、影像学检查、麻醉方式及手术治疗等方面的概况. 结果 2 000例中,72.5%的患儿年龄1~3岁,82.5%异物种类以植物性为主,52.4%异物发生在右侧主支气管,98.7%的三维重建CT诊断符合率,明显高于胸部X线的82.0%(P<0.01).经过手术治疗,治愈1 985例,死亡15例.治愈中9例经局麻下取出异物,其余1 976例均在全麻下行支气管镜检术取出.结论 快速诊断,准确的影像学检查,及时的手术治疗可有效降低气管异物的误诊率及死亡率.

关键词: 支气管, 异物, 气管, 儿童

Abstract: Objective To investigate the clinical characteristics, diagnosis and treatment of tracheobronchial foreign bodies in children. Methods Clinical data of 2 000 cases of tracheobronchial foreign bodies in children were retrospectively analyzed, including children's age, diagnosis, type and site of foreign bodies, imaging examination, type of anesthesia and surgical approach. Results Of all cases, 72.5% occurred in children aged 1-3; 82.5% foreign bodies were plant-based; 52.4% foreign bodies were found in the right main bronchus; 98.7% result of 3D reconstruction of CT was confirmed, which was significantly higher than that of chest X-ray (82%, P<0.01). After operation, 1 985 cases were cured, of which 1 976 cases received general anesthesia and 9 received local anesthesia; 15 cases died. Conclusion There is high incidence of tracheobronchial foreign bodies in children. Timely diagnosis, accurate imaging examination, and timely surgical treatment can effectively reduce the misdiagnosis rate and mortality. Positive and effective health promotion is the key to prevent the occurrence of tracheal foreign bodies in children.

Key words: Bronchi, Child, Trachea, Foreign bodies

中图分类号: 

  • R768.13
[1] Rodríguez H, Passali G C, Gregori D, et al. Management of foreign bodies in the airway and oesophagus[J]. Inter J Pedia Otorhinolaryngol, 2012, 76(1):84-91.
[2] 张杰, 张亚梅. 降低小儿气管支气管异物并发症及病死率的诊断和治疗方案分析[J]. 中华耳鼻咽喉科杂志, 2004, 39(2):658-662. ZHANG Jie, ZHANG Yamei. How to reduce the incidence of complication and mortality in pediatric tracheobronchial foreign body patients[J]. Chin J Otorhinolaryngol, 2004, 39(2):658-662.
[3] 薛刚, 尚小领, 林彦涛. 气管支气管异物3018例临床分析[J]. 中国耳鼻咽喉颅底外科杂志, 2008, 14(5):372-374. XUE Gang, SHANG Xiaoling, LIN Yantao. Clinical analysis on 3018 cases with tracheobronchial foreign body[J]. Chin J Otorhinolaryngol Skull Base Surg, 2008, 14(5):372-374.
[4] 梁建民, 张向红, 汪立, 等. 儿童呼吸道异物误诊的危害性及预防[J]. 中国儿童保健杂志, 2006, 14(4):357-360 LIANG Jianmin, ZHANG Xianghong, WANG Li, et al. Hazard of the misdiagnosis and prevention for foreign bodies in respiratory tract in children[J]. Chin J Child Health Care, 2006, 14(4):357-360.
[5] 王辉腾, 王智楠, 邵剑波, 等. CT在小儿呼吸道异物诊断中的价值[J]. 临床耳鼻咽喉头颈外科杂志, 2006, 20(21):982-983. WANG Huiteng, WANG Zhinan, SHAO Jianbo, et al. The value of spiral CT scan to diagnose the respiratory tract foreign body with negative chest X-rays[J]. J Clin Otorhinolaryngol (Chin), 2006, 20(21):982-983.
[6] Huang H Y, Fang H Y, Chen H C, et al. Three-dimensional computed tomography for detection of tracheobronchial foreign body aspiration in children[J]. Pedia Surg Inter, 2008, 24(2):157-160.
[7] Shin S M, Kim W A, Cheon J E, et al. CT in children with suspected residual foreign body in airway after bronchoscopy[J]. Am J Roentgenol, 2009, 192(6):1744-1751.
[8] 吴宝俊, 李文妍, 许珉,等. 儿童呼吸道异物的误诊误治[J]. 临床耳鼻咽喉头颈外科杂志, 2011, 25(20):933-936. WU Baojun, LI Wenyan, XU Min, et al. The misdiagnosis and erroneous treatment for airway foreign body in children[J]. J Clin Otorhinolaryngol (Chin), 2011, 25(20):933-936.
[9] Betalli P, Rossi A, Bini M, et al. Update on management of caustic and foreign body ingestion in children[J]. Diagn Ther Endosc, 2009, 1155(8):968-969.
[10] 王玮, 李兆龙. 电子喉镜在小儿支气管异物取出术的应用体会[J]. 临床肺科杂志, 2013, 18(4):767-768. WANG Wei, LI Zhaolong. Application of electronic laryngoscope in tracheobronchial foreign body in children[J]. J Clin Pulm Med, 2013, 18(4):767-768.
[11] 黄友棣, 陶礼华. 小儿气管支气管异物取出术后支气管肺泡灌洗的应用[J]. 中国耳鼻咽喉颅底外科杂志, 2004, 10(2):105-106. HUANG Youli, TAO Lihua. Application of bronchoalveolar lavage after removing tracheal or bronchial foreign bodies in children[J]. Chin J Otorhinolaryngol Skull Base Surg, 2004, 10(2):105-106.
[12] 潘宏光, 李兰, 梁振江, 等. 小儿气管支气管异物368例临床诊治分析[J]. 临床耳鼻咽喉头颈外科杂志, 2010, 24(12):544-546. PAN Hongguang, LI Lan, LIANG Zhenjiang, et al. Clinical analysis on 368 children cases with tracheobronchial foreign body[J]. J Clin otorhinolaryngol (Chin), 2010, 24(12):544-546.
[1] 刘冰,李蓓,张莉,陈敏,张杰. 学龄前和学龄期BPV患儿临床特征比较[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 58-60.
[2] 许明,罗兴谷,唐洪波,江青山. 儿童突发性聋的临床特征及预后相关因素分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 41-44.
[3] 刘大炜,张宇,李成林,陈秀梅,宋西成. 加速康复外科在儿童OSAS围手术期中的应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 19-22.
[4] 梁波,黄埔,李雪梅,李岩. 颌下支气管源性囊肿一例[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 113-114.
[5] 徐宏鸣,顾美珍,陈芳,蒋钰钢,李晓艳. 小儿喉腔三维有限元模型构建的方法及意义[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 82-85.
[6] 刘大波. 重视儿童阻塞性睡眠呼吸暂停低通气综合征睡眠结构紊乱[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 6-8.
[7] 李延忠,张泰. 关于儿童阻塞性睡眠呼吸暂停低通气综合征我们面临的问题[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 1-5.
[8] 许志飞,倪鑫. 重视阻塞性睡眠呼吸暂停低通气综合征儿童腺样体[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 9-13.
[9] 王岩,师晓丽. 变态反应与儿童OSAHS的关系[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 14-18.
[10] 杨微,郑莉,许志飞. 中重度阻塞性睡眠呼吸暂停低通气综合征儿童无创正压[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 19-24.
[11] 仇书要,刘大波,钟建文,杨李强. 儿童阻塞性睡眠呼吸暂停低通气综合征等离子[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 34-37.
[12] 钟建文,刘大波,罗向前,黄振云,仇书要,程超,杨李强,易新华,曾锦鸿. 可穿戴设备在儿童阻塞性睡眠呼吸暂停诊断中的应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 30-33.
[13] 罗铮铮,杜宝文,徐志坚. 瓷片异物致食管穿孔、颈部气肿、纵膈气肿一例并文献复习[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 93-96.
[14] 张剑伟,倪泽,唐东亮,徐金. OSAHS患者手术麻醉中应用纤维喉镜引导经鼻行气管插管[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 61-64.
[15] 孙国臣,孙彦,张虹,王保为. 儿童分化型甲状腺癌的临床特征及治疗体会[J]. 山东大学耳鼻喉眼学报, 2017, 31(6): 25-28.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
网站版权所有 © 2018 《山东大学耳鼻喉眼学报》编辑部　
地址：山东省济南市山大南路27号（250100）电话：+86-0531-88366912 E-mail: ebhxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发