儿童支气管异物位置分布及并发症影响因素分析

Affecting factors of bronchial foreign body distribution and complications

目的:探讨影响儿童支气管异物分布及并发症的因素。方法:回顾性分析经支气管镜确诊为支气管异物的患儿523例,所有患儿术前均行多排螺旋CT检查,在多平面重建(MPR)图像上测量异物的长径、宽径及平均大小。分别比较左、右支气管异物及相应并发症阻塞性肺气肿、肺炎的不同特点,并进行统计学分析,获得影响支气管异物左右分布、不同并发症的影响因素。结果:左、右支气管异物比较,右侧支气管的异物宽径及平均大小较左侧大,差异有统计学意义(P<0.05),而患儿年龄、就诊时间、性别比例及异物长径、异物类型则无差异。与无阻塞性肺气肿比较,阻塞性肺气肿患儿年龄小、就诊时间长,异物类型为食物多见(P<0.05),而性别比例及异物的长径、宽径、平均大小无差异。与无肺炎组比较,肺炎组患儿年龄大、就诊时间长,异物长径和平均大小较大(P<0.05),而性别比例、异物类型、异物宽径则无明显差异。结论:异物的宽径、平均大小是支气管异物分布的影响因素,而患儿年龄、就诊时间、异物类型、异物长径、平均大小等因素影响支气管异物主要并发症的发生。

Objective： To evaluate the factors affecting the distribution of bronchial foreign bodies and the occurring of complications. Methods： 523 cases of bronchial foreign body, which were confirmed by bronchoscope,were retrospectively analyzed. All of the cases were examined with multi-detector CT scanner before bronchoscope. Then the CT datas were reconstructed with minimum intensity projection（ Min P） and multiple planar reconstruction（ MPR）. The length,the width,and average size of foreign bodies were measured on MPR. Different characteristics of left and right foreign bodies and its complications including obstructive emphysema and pneumoniawere respectively compared. The affecting factors of bronchial foreign bodies distribution and its complications were obtained. Results： Compared with left bronchial foreign bodies,right bronchial foreign bodies had bigger width and average size,and the difference was statistically significant（ P 〈 0. 05）,while the age,visiting time,sex ratio,the length and the types of foreign bodies had no difference. Compared with no obstructive emphysema group,obstructive emphysema group had younger age,longer visiting time,and more food foreign bodies（ P 〈 0. 05）,while the sex ratio,the length,the width,the average size and the types of foreign bodies had no difference.Compared with no pneumonia group,pneumonia group had older age,longer visiting time,bigger length and average size（ P 〈 0. 05）,while sex ratio and foreign bodies types and the width had no difference. Conclusion：The width and average size of foreign bodies are affecting factors of bronchial foreign bodies distribution. The age,visiting time,the types of foreign bodies,the length,the width and the average size of foreign bodies affect the occurring of main bronchial foreign body complications.