成人特殊类型支气管异物患者23例治疗体会

Adult patients with special bronchial foreign bodies: treatment experience in 23 cases

目的提高成人特殊类型支气管异物的诊断及治疗水平。方法回顾性分析2003年1月至2014年1月在广西医科大学第一附属医院呼吸内科住院治疗的成人特殊类型支气管异物患者的临床资料。结果共收治特殊类型支气管异物患者23例，其中男15例，女8例；年龄25．5～74岁，中位年龄55．3岁；病史10至50年。23例患者中能提供明确异物误吸病史者11例；患者均有不同程度的异物周围气道炎症、肉芽组织增生及异物嵌顿；经纤维支气管镜取出异物21例（91．3％），因高度疑癌转外科手术治疗1例，因反复取异物失败最终放弃治疗1例。结论纤维支气管镜下取成人支气管异物简单安全、异物取出卒高；对于特殊类型支气管异物，术前、术中做好充分准备可提高手术安全性及取出成功率。

Objective To improve the diagnostic rate and therapeutic level of adult patients with special bronchial foreign bodies. Methods The clinical data of adult patients with special bronchial foreign bodies admitted to the First Affiliated Hospital of Guangxi Medical University between January 2003 to January 2014 were retrospective analyzed. Results 23 patients with special bronchial foreign bodies aged from 25.5 to 74 years （ age of 55.3 years） were recruited to our study, including fifteen males and eight females. Duration of residence of the foreign bodies were ten to fifty years, and 11 cases can provide a clear history of foreign bodies aspiration before operations; different levels of peripheral airway inflammation, granulation tissue hyperplasia and foreign body were found in 23 patients; the foreign bodies in 21 cases （91.3 % ） were successfully removed by using flexible bronchoscope, 1 case was sented to surgery for highly suspected of carcinoma, 1 case finally abandoned treatment for repeated failure of removal of foreign body. Conclusions Flexible bronchoscope is a kind of simple, safe and effective method in removing bronchial foreign bodies, fully prepared beore and during the procetures can enhanced the safety and success rate for removal of special bronchial foreign bodies.