儿童气道异物误诊37例分析

Analysis on misdiagnosis of airway foreign body in 37 children

目的探讨小儿气道异物误诊原因,提高气道异物的诊断水平,降低误诊、漏诊率。方法分析我院2016年1月-2018年12月中37例气道异物误诊患儿的临床资料及诊治经过,并列举4例典型病例。结果 37例患儿均在全麻硬性支气管镜下取出异物。异物吸入史者仅9例,无异物吸入史28例;声门异物10例,总气管内异物7例,左侧支气管异物11例,右侧支气管异物9例。结论提高看护人员及医师对儿童气道异物特点的认识是降低误诊率、死亡率的关键,重视异物吸入史,可疑病例应详尽影像学检查是避免误诊的重要举措,必要时应尽早行支气管镜检查明确诊断。

Objective To discuss the causes of misdiagnosis of airway foreign body in children and improve the diagnosis level of airway foreign body. To reduce the rate of misdiagnosis and missed diagnosis.Methods The clinical data of 8 cases of misdiagnosed airway foreign body in our hospital from 2016-01 to 2018-12 were analyzed, and the diagnosis and treatment of 4 typical cases were listed.Results The foreign bodies were removed under the rigid bronchoscope under general anesthesia. There were only 9 cases with foreign body inhalation history, 28 cases without foreign body inhalation history. There were 10 cases with glottic foreign body, 7 cases with foreign body in the general trachea, 11 cases with foreign body in the left bronchus and 9 cases with foreign body in the right bronchus.Conclusion It is the key to reduce the misdiagnosis rate and mortality rate to improve the doctors’ understanding of the characteristics of foreign body in children’s airway. Detailed imaging examination of suspicious cases is an important measure to avoid misdiagnosis. Bronchoscopy should be performed as soon as possible if necessary to clarify the diagnosis.