气管及支气管异物治疗体会(附533例分析)

EXPERIENCE IN THE TREATMENT OF FOREIGN BODIES IN THE TRACHEA AND BRONCHUS:WITH AN ANALYSIS OF 533 CASES

本文总结气管及支气管异物533例,1~2岁占44.29%。正气管异物占26.3%,右支气管异物占42%,左支气管异物占32.6%:植物性异物占82.9%,金属异物占8.3%,其他异物占8.9%。有明确异物吸入史者占97.7%,出现气管拍击音者占正气管异物的45.93%,支气管异物中患侧呼吸音低者占82.16%,胸透有纵膈摆动者占70.85%,肺不张占27.64%,肺气肿占25.88%,肺炎占11.6%。经直达喉镜取出者占23.3%,经气管镜取出者占75.6%,咳出及开胸各占0.6%。金属异物50%在全麻透视下取出。

The present puper sums up 533 cases of foreign bodies in the trachea and the bronchus.Among these patients.44.29%were 1~2 years of age,25.3%had foreign bodies in the trachea.42%had them in the right bronchus,and 32.6%in the left bronchus.Foreign bodies of plant origin made up 82.9%of the cases,metalic foreign bodies made up 8.3%,and foreign bodies of various nature made up the remaining 8.9%.97.7%of the cases had a dear history of inhaling a foreign body into the air passages.Among the cases with foreign bodies in the trachea,a fluttering sound could be heard in 45.93%of the patients.In those with foreign bodies in the bronchus.82.16%showed a diminished breathing sound on the affected side,70.85%showed deviations of the mediastinium in fluoroscopy,27.64%had atecectasis.25.88%had lung abscess,and 11.6%had pneumonitis.Of these foreign bodies 23.3%were removed by direct laryngoscopy,and 75.6%by tracheoscopy.Patients who coughed out the foreign bodies and those in whom the foreign bodies were removed through thoracotomy each comprised 0.6%of the cases.50%of the metalic foreign bodies were removed under general anaesthesia under fluoroscopy.