成人气管和支气管异物的诊治

Management of tracheobronchial foreign bodies in adults

目的探讨成人气管支气管异物的临床特点以及诊治。方法回顾性分析我院1996年1月至2010年1月收治的24例成人气管支气管异物的病例资料,其中男16例,女8例,年龄18～85岁。结果成人气管支气管异物种类多样,临床表现各异,容易漏诊,其中有1例漏诊长达7年之久。24例中,有10例行硬质支气管镜下取出异物;7例纤维支气管镜下取出异物;3例患者入院后自行咳出异物;1例在支撑喉镜下取出异物;1例急诊行气管切开异物取出术;共治愈22例,死亡2例。结论成人气管支气管异物少见,临床表现各异,容易误诊。绝大多数成人气管和支气管异物可通过纤维支气管镜或硬性气管镜处理而痊愈。

Objective To investigate the clinical characteristics and experiences of tracheobronchial foreign bodies in adult patients.Methods The clinical data of 24 cases（16 men and 8 women;age range 18-85 years）with tracheobronchial foreign bodies admitted between January 1996 and January 2010 were retrospectively analyzed.Results The foreign tracheobronchial bodies in adult patients were varied.The foreign bodies were successfully removed in all but 2 patients.One case with the foreign body was taken out by direct laryngoscopy,one case was subjected to emergency tracheotomy,10 cases were subjected to rigid bronchoscopies and the other 7 cases were subjected to flexible bronchoscopy.3 patients after admission coughed up the foreign bodies.Conclusions Foreign bodies in the tracheobronchial system are rare in adults.Tracheobronchial foreign bodies in adults have a variety of clinical presentations and often go unrecognized.They can be successfully removed in the majority of patients under either flexible or rigid bronchoscopy.