成人气管支气管异物2222例临床Meta分析

Clinical Meta analysis on removal of tracheobronchial foreign bodies in 2222 adults

目的探讨我国成人气管支气管异物患者的临床特点和支气管镜下治疗的有效性和安全性。方法将1986年6月至2016年6月治疗的2 222例成人气管支气管异物患者的临床资料进行回顾性分析。结果成人气管支气管异物2 222例,男性1 520例,女性702例。1 318例患者否认异物坠积。1 950例患者无基础疾病。1 952例(87.84%)患者接受局部麻醉下支气管镜镜下治疗,成功取出气道异物。主要的临床症状为咳嗽1 625例(73.1%)。异物来源为动物骨骼1 036例(46.6%),果肉、果核类358例(16.1%),金属异物122例(5.49%),义齿和破损牙齿136例(6.12%)。异物引发的并发症有阻塞性肺炎740例(33.3%),肺不张340例(15.3%)。操作过程中及治疗完成后气道内出血143例(6.43%)。3例患者死于窒息。结论成人的气管支气管异物没有典型的临床症状;在表面麻醉下经支气管镜取出成人气管支气管异物是有效的、安全的。

Objective To study the clinical characteristics of adult patients with tracheobronchial foreign bodies in China and the effectiveness and safety treated by flexible bronchoscope. Methods The clinical data of 2 222 patients with tracheobronchial foreign bodies treated from June 1986 to June 2016 were retrospectively analyzed. Results A total of 2 222 adult patients（1 520 men and 702 women） with tracheobronchial foreign bodies were analyzed. 1 318 cases denied the history of foreign body aspiration. 1 950 cases were no previous disease. 1 952 cases（87.84%） were treated through flexible bronchoscope under topical anesthesia. Cough was the main symptom（1 625 cases,73. 1%）. The most tracheobronchial foreign bodies included bones（1 036 cases,46.6%）,pulp and nut shells（358 cases,16.1%）,metal foreign bodies（122 cases,5. 49%）,false and broken teeth（136 cases,6. 12%）. Foreign body-induced complications were obstructive pneumonia（33. 3%） and atelectasis（15. 3%）. Hemorrhage was found in 143 cases（6. 43%）following flexible bronchoscopic examination. 3 cases died of asphyxia. Conclusion There are not typical symptoms for adult patients with tracheobronchial foreign bodies. The removal of tracheobronchial foreign bodies in adults by flexible bronchoscope is effective and safe under topical anesthesia.