电子纤维支气管镜治疗小儿气管支气管异物101例临床疗效分析

Clinical efficacy analysis of electronic fiberoptic bronchoscopy for the treatment of tracheobronchial foreign bodies in 101 children

目的探讨电子纤维支气管镜治疗小儿气管支气管异物的临床效果。方法选取2016年1月至2018年10月安徽医科大学附属安徽省儿童医院收治的气管支气管异物病儿101例,术前均行咪达唑仑镇定、利多卡因表面麻醉后,经电子纤维支气管镜钳取异物治疗,分析其相关临床资料及治疗效果。结果经电子纤维支气镜成功取出气管支气管异物病儿98例,成功率97.03%,一次性操作取出异物91例(92.86%),2次及以上取出异物7例(7.14%)。异物以植物类为主(88例),占87.13%,以花生、瓜子最为常见;吸入异物的部位右侧55例(54.46%),左侧42例(41.58%),双侧支气管3例(2.97%),1例位于声门下(0.99%);术前98例病儿行肺部CT检查确诊72例(73.47%)。101例病儿术中、术后均无明显呼吸困难、喉痉挛、咯血及声嘶等并发症。结论电子纤维支气管镜可有效诊治病儿近端及远端气管支气管异物导致的肺炎、肺不张等并发症,安全有效,减轻并降低病儿远期痛苦,有逐渐取代五官科硬支气管镜取气道异物的趋势,临床可作为诊治气道异物首选方法。

Objective To analyze the clinical therapeutic effect by electronic fiberoptic bronchoscopy for the treatment of tracheobronchial foreign bodies in 101 children.Methods One hundred and one children with tracheobronchial foreign body admitted to the department of respiratory medicine of Anhui Medical University Affiliated Anhui Children’s Hospital from January 2016 to October 2018 were selected.All patients were treated with midazolam sedation and lidocaine surface anesthesia before the operation,and the foreign body was treated by electronic fiberoptic bronchoscopy.The related clinical data and treatment effect were analyzed.Results 98 children with tracheobronchial foreign body disease were successfully removed through electronic fiberoptic bronchoscopy,and the success rate is 97.03%.The removal of foreign body by one-time operation:91 cases(92.86%),2 times or over removal of foreign body:7 cases(7.14%).The foreign bodies were mainly plants(88 cases),accounting for 87.13%,and peanuts and melon seeds were the most common;there were 55 cases(54.46%) on the right side of the inhaled foreign body,42 cases(41.58%)on the left side,3 cases(2.97%)on both sides of the bronchus,and 1 case(0.99%)under the glottis;72(73.47%)of the 98 cases were confirmed by lung CT examination before operation.There were no obvious complications such as dyspnea,laryngeal spasm,hemoptysis and hoarseness during and after operation in 101 children.Conclusion Electronic fiberoptic bronchoscopy can effectively diagnose and treat pneumonia,atelectasis and other complications caused by proximal and distal tracheobronchial foreign bodies in children,is safe and effective,and it can relieve and reduce the long-term pain of children,there is a tendency to replace rigid bronchoscope in the department of ent to pick up foreign body in the airway,which can be used as the preferred method for the diagnosis and treatment of foreign body in the airway.