397例儿童呼吸道异物临床分析

Clinical Analysis of 397 Children with Airway Foreign Bodies

目的:探讨儿童呼吸道异物的临床特点及与术前肺部并发症的相关性,以指导临床治疗,减少并发症发生。方法:分析重庆医科大学附属儿童医院2012年收治的397例儿童呼吸道异物病例的临床资料,根据年龄分成婴儿组(<1岁)、幼儿组(1~3岁)、学龄前儿童组(>3岁~5岁)、学龄期儿童组(>5岁~12岁)。按病程分为:甲组(病程<24 h)、乙组(病程24 h^10d)、丙组(病程>10 d);按异物位置分为:A组(气管隆突及以上)、B组(左右主支气管开口)、C组(叶、段支气管)。结果:397例患儿中,婴儿组植物性异物50例,动物性异物9例,化学合成品异物1例;幼儿组植物性异物261例,动物性异物5例,化学合成品异物3例,金属性异物2例;学龄前儿童组植物性异物50例,化学合成品类异物2例;学龄期儿童组植物性异物5例,化学合成品类异物9例。引起术前肺部并发症的异物中植物性异物最常见。异物在气道存留时间、存留位置对术前肺部并发症发生率的影响差异有统计学意义(P<0.05)。结论:(1)儿童呼吸道异物的并发症发生率与病程、异物位置、异物类型有一定关系,及时就诊可降低并发症发生率。(2)植物性异物为呼吸道异物的主要类型,也是造成术前肺部并发症的主要类型,动物性异物主要发生在婴幼儿,化学合成异物主要发生在学龄期儿童。加强对民众的健康宣传教育,对各年龄段儿童呼吸道异物采取不同预防措施甚为重要。

Objectiv： To explore the clinical characteristics and the influence factors of preoperative pulmonary complications of pediatric foreign bodies, and to reduce its complication and morbidity. Methods： Analyze the clinical data of 397 cases of children with airway foreign bodies in 2012 in Children＇s Hospital of Chongqing Medical University. According to age, they were divided into an infant group （〈1 year）, a child care group （1 -3 years）, a preschool group （〉3 -5 years）, and a school age group （〉5 -12 years）. According to course of disease, they were divided into group A （duration 〈24 hours）, group B （duration between 24 hours to 10 days） and group C （duration 〉10 days） According to the foreign bodies position, they were divided into group A （carina of trachea and above）, group B （left and right main bronchus opening） and group C （leaves, segmental bronchi）. Results： In 397 patients, there were 50 cases with plant foreign bodies, 9 cases with animal foreign bodies, and 1 cases with chemical compounds foreign bodies in the infant group; in the child care group, 261 cases with plant foreign bodies, 5 cases with animal foreign bodies, 3 cases with chemical compounds foreign bodies, and 2 cases with metallic foreign bodies; in the preschool group, 50 cases with plant foreign bodies, and 2 cases with chemical compounds foreign bodies; in the school age group, 5 cases with plant foreign bodies, and 9 cases with chemical compounds foreign bodies. Plant foreign bodies were most common in foreign bodies causing preoperative pulmonary complications. There were significant differences between foreign bodies retention time, location and the preoperative pulmonary complication rate （P〈0. 05）. Conclusions： The complication rate of airway foreign bodies in children may have a certain relationship with the course of the disease, foreign bodies position and foreign bodies types. Timely treatment can reduce the incidence of complications. Plant foreign bodies is the main type of airway foreign bodies, also contributes to the major type causing preoperative pulmonary complications. Animal foreign bodies occurs mainly in infants and young children, and the chemical synthesis of foreign bodies occurs mainly in sebool-age children. , It is important to take precautions for all ages and strengthen education of public health.