学龄期儿童呼吸道异物特点分析及预防

Features Analysis and Prevention of Airway Foreign Bodies in School-age Children

目的探讨发生在学龄期儿童(6～12岁)呼吸道异物的特点和预防。方法分析1993-2007年收治的178例学龄期儿童气管、支气管异物的病例资料。结果178例中,农村患者147例,城市31例;男性142例,女性36例;110例为化学合成品,54例为植物性异物,10例为矿物性异物,3例为动物性异物,1例种类不明。167例经直接喉镜或硬管支气管镜取出,4例自行咳出,3例开胸取出,3例经气管切开取出,1例行左肺切除术,无死亡病例。结论与婴幼儿和学龄前儿童不同,学龄期儿童以化学合成品类异物最常见;玩具零件和文具零件是学龄期最多见的异物,应重点预防;健康教育的缺乏是导致农村患儿发病率高的原因之一。

Objective To study the types of airway foreign bodies in school- age children aged between 6- 12 years, and to explore the preventive methods. Methods The clinical records of 178 school - age children with tracheal or bronchial foreign bodies from 1993 to 2007 were reviewed and analyzed. Results There were 147 rural children and 31 urban children suffered from airway foreign bodies, including 142 boys and 36 girls. The 110 foreign bodies were plastic materials, followed by .54 vegetable materials, 10 mineral materials, 3 animal bones and the remaining 1 unidentified. Altogether 167 foreign bodies were removed with direct laryngoscope or rigid bronchoscope, 4 cases were coughed out by themselves, 3 cases were removed through thoracobronchotomy, 3 cases were removed through tracheotomy, and 1 case received left pneumonectomy. No death occurred. Conclusions In contrast to vegetable foreign bodies commonly occurring in infants and preschool- age children, plastic materials are the most common airway foreign bodies in school- age children. The little spare parts of toys and stationeries are the predominant airway foreign bodies, and also the key of prevention in school - age children. Poor health education on airway foreign bodies is likely to be one of the reasons for high incidence in the rural districts.