早产低体质量儿气管支气管异物的治疗

Treatmeat of tracheobronchial foreign bodies in preterm low birth weight children

目的探讨早产低体质量儿气管支气管异物的治疗方法。方法选择新乡医学院第一附属医院耳鼻喉科120例气管支气管异物患儿,其中足月正常体质量儿102例,早产低体质量儿18例,对其临床资料进行回顾性分析。结果 120例患儿中术前伴并发症33例,其中32例经积极对症治疗及手术治疗治愈出院,1例死亡;33例出现并发症的患儿中,早产低体质量儿15例(83.33%),足月正常体质量儿18例(17.65%),早产低体质量儿患气管支气管异物后并发症发生率显著高于足月正常体质量儿(P<0.05)。1例(5.56%)早产低体质量儿气管支气管异物取出术中出现双侧气胸和纵隔气肿,压迫心脏,出现心跳停止,经抢救无效死亡;而足月正常体质量患儿无死亡病例,足月正常体质量儿病死率显著低于早产低体质量儿(P<0.05)。结论早产低体质量儿气管支气管异物患儿并发症发生率及病死率较足月正常体质量儿支气管异物患儿高,临床上应高度重视,术前充分准备,术中谨慎小心,掌握常规的急救技能,可有效降低其并发症发生率及病死率。

Objective To analyze the clinical treatment of tracheobronchial foreign bodies in preterm low birth weight children retrospectively.Methods The clinical data of 120 cases of tracheobronchial foreign bodies in Department of Otolaryngology,the First Affiliated Hospital of Xinxiang Medical University were analyzed,among which there were 102 cases of mature normal birth weight children and 18 cases of preterm low birth weight children.Results Among the 120 cases,there were 33 cases had complications,including 32 cases who had symptomatic treatment and surgical treatment and then cured and discharged,1 case died.Among the 33 cases with complications,there were 15 cases（83.33%） of preterm birth and low body mass and 18 cases（17.65%） of mature normal birth weight,the probability of complications after tracheal bronchus foreign body in preterm birth and low body mass patients was significantly higher than that in normal body mass patients（P0.05）.Premature birth and low body mass in 1 cases（5.56%） had intraoperative bilateral pneumothorax,mediastinal emphysema,the oppression of the heart,cardiac arrest and died.No death case was found in mature normal birth weight patients.The death rate of them was different significantly（P0.05）.Conclusion Complication rate and mortality rate of preterm low birth weight tracheobronchial foreign body patients are higher than those of mature normal birth weight tracheobronchial foreign body patients,which should be paid attentions in clinic.Some measures may be effective for reducing complication rate and mortality rate such as good preparations before operation,careful action in operation and routine skill of emergency.