小儿呼吸道异物187例临床分析

Clinical Experience of Removing Respiratory Tract Foreign Bodies With Rigid Endoscopy in Children

目的探讨小儿呼吸道异物的取出方法和治疗效果。方法分析187例小儿呼吸道异物患者诊断、麻醉、手术方法及治疗效果。无麻醉下支气管镜异物取出术5例;全麻下支气管镜异物取出术182例,其中经气管切开处插入支气管镜取出异物6例。结果187例在无麻或全麻下经支气管镜成功取出异物,其中184例1次手术成功取出异物,占98.4%,2例经过2次手术成功取出异物,占1.1%,治愈186例,治愈率99.5%,死亡1例,病死率0.5%。结论早期正确诊断,术前处理好并发症,及时选择合适的治疗方法,是提高小儿呼吸道异物治愈率、降低并发症及病死率的有效手段。

Objective This study was undertaken to document the respiratory tract foreign body accidents among children, and to investigate the circumstances surrounding these events. Methods A review of the charts of pediatric patients admitted with the definitive or suspicious diagnosis of respiratory tract foreign bodies was carried out in the period between July, 1996 to May,2006. There were 187 eligible children; 106 boys and 81 girls,with an age range of 8 months to 1 lyears. Results In 184 cases （98.4%）foreign bodies were removed successfully in the first time, while 2 cases （1.1% ） were removed successfully in the second time. One patient （ 0.5 % ） died due to cardiac arrest. Conclusion Foreign bodies in the airway and esophagus constitute a constant hazard in all age groups, which demands immediate approach and management. Although the rigid endoscopic removal of respiratory foreign bodies was successful in this series, the most effective treatment of foreign body accidents is their prevention.