小儿喉内嵌顿性异物60例急救分析

Analysis of 60 cases of throat incarcerated foreign body in children

目的分析小儿喉内嵌顿性异物的临床表现,为今后的急救治疗做理论基础。方法选取我院2012—2016年收治的小儿喉内嵌顿性异物患儿60例作为研究对象,根据患儿喉内嵌顿的类型,选择合适的麻醉方式和手术方式进行急救,通常采用的手术方案有直接喉镜检手术和气管切开手术,分析小儿喉内嵌顿性异物的患儿急救措施及效果。结果 60例患儿中,出现II度呼吸困难患儿有23例,III度呼吸困难患儿有22例,IV度呼吸困难患儿有12例,窒息死亡患儿有3例。异物包括有石榴籽12例,花生米22例,图钉1例,塑料玩具碎片有3例,果冻有12例,猪骨有10例。采用直接喉镜检手术的有37例,采用气管切开手术的有23例。60例患儿有57例患儿成功取出异物,有3例患儿抢救无效、死亡,患儿的治疗有效率为95.0%。结论小儿喉内嵌顿性异物疾病属于临床急症,常发生与2岁以内的患儿,但若抢救不及时死亡率非常高。因此,小儿喉内嵌顿性异物的急救在临床上的价值非常高,需要根据患儿的实际情况选择合适的手术进行抢救,从而保证患儿的生命安全。如果患儿的病情允许的情况下,可以进行全身麻醉,避免患儿挣扎造成患儿缺氧。

Objective To analyze the clinical manifestations of throat incar cerated foreign body in children, andprovide theory basis for the emergency treatment in future. Methods From 2012 to 2016, 60 cases of throatincarcerated foreign body in children were selected as the research objects, and all the children were given theappropriate anesthesia and surgical methods for emergency treatment according to the types of incarcerated foreignbody in children, and the common surgical options were the direct laryngoscopy and tracheotomy surgery, theemergency measures and results of throat incarcerated foreign body were analyzed. Results Of the 60 children, therewere 23 children with grade II dyspnea, 22 children with grade III dyspnea, 12 children with grade IV dyspnea and3children with suffocation. The foreign bodies included 12 cases of pomegranate seeds, 22 cases of peanuts, 1 case ofthumb tacks, 3 cases of plastic toy pieces, 12 cases of jelly and 10 cases of pig bones. Thirty -seven childrenunderwent direct laryngectomy and 23 children underwent tracheotomy. Of the 60 children, 57 children weresuccessfully removed foreign bodies, 3 cases were ineffective and died, the effective rate was 95.0%. ConclusionChildren with throat incarcerated foreign body disease belong to clinical emergency, which occured in children within2years of age, but if the rescue is not in time, the mortality rate is very high. Therefore, the first emergency in throatincarcerated foreign body disease has very high in the clinic, and need to choose the appropriate surgical rescueaccording to the actual situation of children, so as to ensure the safety of children＇s lives. If the children conditionallow, general anesthesia can be used to prevent children struggling caused by hypoxia.