气管、支气管内特殊异物取出术的临床研究

Clinical study of the uncommon tracheobronchial foreign bodies

目的探讨气管、支气管内特殊异物的手术方法,提高手术成功率。方法气管、支气管内特殊异物30例,分别应用支气管镜、气管切开及开胸手术等不同方法将异物取出。结果93.3%(28/30)异物在支气管镜下取出,其中应用反张钳取异物占33.3%(10/30),成功率为90.0%(9/10);应用鳄鱼嘴钳取异物占20.0%(6/30),成功率为83.3%(5/6);应用普通异物钳取异物占30.0%(9/30),成功率为100%(9/9);应用尖嘴钳取异物占6.7%(2/30),成功率为100%(2/2);应用成人食管镜钳取异物占10.0%(3/30),成功率为100%(3/3);支气管镜下未取出病例分别经气管切开及开胸手术取出,成功率为100%(2/2)。结论只有根据异物特点选择合适异物钳,并设计合理的手术方法才能将气管、支气管内特殊异物顺利取出。

[Objective] To explore the operation methods of the uncommon tracheobronchial foreign bodies in order to increase the operation success rates. [Method] We did 30 operations of the uncommon tracheobronchial foreign bodies with the methods of bronchoscopy, tracheotomy and thoracotomy. [Result] 93.3% （28/30）, 3.3% （1130） and 3.3% （1/30） of the foreign bodies were removed with the method of bronchoscopy, tracheotomy and thoracotomy, respectively. 33.3% （10130） of the foreign bodies were removed with inverted forceps, and the success rate was 90.0%（9/10）. 20.0% （6/30） of the foreign bodies were removed with alligator forceps, and the success rate was 83.3% （5/6）. 30.0% （9/30） of the foreign bodies were removed with common forceps, and the success rate was 100%（9/9）. 6.7% （2/30） of the foreign bodies were removed with sharp forceps, and the success rate was 100%（2/2）. 10.0% （3/ 30） of the foreign bodies were removed with adult esophagoscope forceps, and the success rate was 100%（3/3）. 6.7% （2/30） of the foreign bodies were removed with the methods of tracheotomy or thoracotomy, and the success rate was 100% （2/2）. [Conclusion] The uncommon tracheobronchial foreign bodies can be removed successfully by choosing appropriate forceps on the basis of the characteristics of foreign bodies and designing reasonable operation methods.