特殊类型呼吸道异物的诊断与治疗

The diagnosis and treatment of special airway foreign body

目的:探讨特殊类型呼吸道异物的诊断与治疗。方法:分析69例特殊类型呼吸道异物患者的临床资料,其中45例在全身麻醉下经支气管镜通过声门取除异物,24例经气管切开取除异物。结果:经支气管镜取除异物的45例患者中43例治愈,2例在异物通过声门时滑脱,发生异物变位,患者因呼吸衰竭死亡;经气管切开取除异物的24例患者全部治愈。8例术后血氧饱和度低于90%,送到ICU病房经正压通气等治疗后恢复正常,总治愈率为97.1%。结论:特殊类型呼吸道异物可在全身麻醉下经支气管镜通过声门取出;但对年龄较小,有肺不张,异物较大而且形状不规则的患者应通过气管切开取除异物更安全。

Objective.The aim of this study was to discuss the diagnosis and treatment of special airway foreign body. Method： Clinical data of 69 patients with airway foreign body were analyzed ,of which 45 patients underwent rigid bronchoscopy while another 24 patients underwent tracheotomy. Result：The operations succeeded in 43 of the 45 patients who underwent rigid bronchoscopy, while the other 2 patients died of respiratory failure because of the foreign body slipping off at the level of the glottis. All of the 24 other patients were cured, in which continuous saturation of blood oxygen below 90% occurred in 8 patients and turned normal after positive airway pressure in intensive care unit （ICU）. The total cure rate reached 97. 1%. Conclusion： Most of special foreign body in the airway can be taken out through tracheotomy under general anesthesia. If the foreign body is too big and irregularly, or the patients is too young or have the pulmonary atelectasis, it is much safer to remove foreign body by tracheotomy.