小儿特殊类型呼吸道异物的诊治体会

The experience of treatment on special types of airway foreign bodies

目的探讨小儿特殊类型呼吸道异物的诊治及手术技巧。方法回顾2010年7月至2015年8月我科收治的122例特殊类型呼吸道异物的诊治及处理过程。患儿最小年龄28d，最大年龄11岁，平均年龄3．6岁。异物种类包括子弹、拉链头、别针、钢钉、玩具灯泡、磁铁、玻璃碎片、苍耳子、螺丝钉、大头针、金属弹簧等。右侧支气管异物54例，左支气管异物18例，声门下异物15例，气管异物33例，双侧支气管异物2例。结果122例中，108例特殊异物经支气管镜子支气管异物钳成功取出，14例大型异物经支气管镜予食道异物钳取出，无一例行气管切开术或开胸手术取异物，无死亡病例。结论小儿特殊类型呼吸道异物手术取出难度较大，应根据异物的种类、嵌入特点及患儿临床表现采用相应的手术方法及技巧取出异物。

Objetive To explore the methods and surgical technique on special types of airway foreign bodies. Methods A retrospective review was made on 122 cases with special type of foreign bodies in our hospital from Jul. 2010 to Aug. 2015. Children were at the ages ranging from 28 days to 11 years,with the average age 3.6 years. Foreign bodies include bullets, zipper head, pin, nail, toys, light bulbs, magnets, broken glass, fructus xanthii, screws, pins, metal springs, etc. Among all the eases, 54 found foreign bodies in the right bronchial, 18 in the left bronchial, 15 in subglottie region, 33 in trachea, and 2 in bilateral bronchial. Results Among all the eases ,108 got the foreign bodies removed successfully with bronchial foreign body forceps, 14 with esophageal foreign body forceps, none underwent tracheotomy or thoracic surgery. No death occurs. Conelusions Operation of foreign bodies removal is hard to perform. Operation method should be designed according to the type and location of foreign bodies, and the symptoms, so that the complications would be minimized.