新乡长垣地区小儿气管异物218例临床分析

目的回顾性分析新乡长垣地区218例小儿气管异物病例的临床特点、诊治过程,总结诊疗体会,制定出合理的健康管理措施,预防小儿气管、支气管异物的发生。方法对218例小儿气管异物的年龄段、性别、临床症状、影像学检查、异物分类、患儿家长受教育程度、治疗结果等多个因素进行统计分析,总结诊疗体会。结果 3岁以下患儿占总数的90.83%（198例）,其中以1-2岁患儿为主,占77.98%（170例）。男孩居多,男女患儿比例为1.9∶1,75.23%患儿（164例）有明确异物吸入史,24.77%（54例）有反复肺部感染病史。本院行胸部CT检查及三维重建均可明确异物位置,异物3岁以下以有机物为主（多为植物性食物,如：花生、瓜子等）,3岁以上多为无机物（如：塑料笔帽、塑料球等）。患者家属受教育程度多在本科以下者占84.86%（185例）。结论 3岁以下儿童为高发人群,异物吸入史是重要的诊断依据,胸部CT及三维重建可明确异物位置。家长文化程度不高、监护不力、缺乏必要的医学常识、并对患儿食物监管不善易造成此病发生,应给家长正确的育儿知识指导;对学龄前儿童进行健康指导,并纠正其不良卫生及饮食习惯;加强社会宣传,提高大众防范意识,预防此类疾病发生。

Objective To sum up clinical experience of 218 cases with the diagnosis and treatment of foreign bodies in bronchus of children in a respective way, make healthy reasonable management measures, prevent the happening of tracheal foreign body in children. Methods A retrospective study was carried out among 218 children with foreign bodies in bronchus treated, with their clinical data analyzed carefully, including such parameters as age, gender, clinical symptom, imaging examination type of foreign body, cultural levels of their parents, and outcomes of treatment, in order to sum up our clinical experience with such a condition. Results In this group of children cases, the ratio of male to female was 1.9 ： 1. With 90.83% being lower than 3 years old, of which 1-2 years old children mainly. 75.23% patients had a clear history of foreign body aspiration, 24.77% had a history of recurrent pulmonary infection. The foreign bodies of children within 3 years old were mostly organic diameter smaller nuts plant foods such as melon seeds and peanuts, while children more than 3 years were mostly inorganic foreign bodies such as cap of a pen or plastic balls. Educational level of parents in the following undergraduate accounted for 84.86%. Gonclusion Children within 3 years old were high risk population, history with foreign body inhalation is the most significant evidence for diagnosis of foreign body in bronchus. In addition, the key step may be elevating parents＇ health information on accident prevention for their children to avoid foreign body in bronchus from occurring.