儿童气管支气管异物诊治686例

Diagnosis and treatment of tracheo-bronchial foreign bodies in 686 children

目的探讨儿童气管支气管异物的临床特征、诊治方法及时机。方法回顾总结686例气管支气管异物患者临床资料,应用硬气管镜、纤维支气管镜、开胸等方法进行治疗,追踪临床转归。结果异物种类中植物性658例(95.9%),小塑料制品7例,金属6例。经硬质气管镜取出气道异物660例,纤维支气管镜取出基底支内异物5例,基底支内异物转胸科手术取出1例,自行咳出1例。结论幼儿期为儿童气管支气管异物的高发年龄段;病情发展迅速、手术风险较大;术中要求迅速、准确取出异物;术后需加强病情监控。

Objective To explore the clinical characteristics,diagnosis,treatment,and proper time for surgery for foreign bodies in the airway of children. Methods The clinical data of 686 children with tracheobronchial foreign bodies were retrospectively summarized. The foreign bodies in the airway were removed with a rigid tracheoscope,fiberbronchoscope or thoracotomy. Clinical outcomes were observed. Results Vegetative foreign bodies were found in 658 cases （95.9%）,while plastic foreign bodies in 7 and metal foreign bodies in 6 cases. The foreign bodies were removed in 660 patients with rigid tracheoscopy. 5 Fiberbronchoscopy and 1 thoracotomy were performed due to the foreign bodies residing in the basal segment of lowed lobe. In one case,the foreign body was coughed out. Conclusion Tracheo-bronchial foreign bodies is a common disease in early childhood. The progress is rapid and the surgery is risky. Quick,accurate removal of the foreign body and intensive post-operative surveillance is required.