硬质支气管镜技术在小儿气管支气管异物取出中的应用效果

Application of rigid bronchoscopy in the removal of tracheobronchial foreign bodies in children

目的观察评价分析硬质支气管镜技术(RB)在小儿气管支气管异物(TFB)取出中的应用价值,以提高TFB的诊断及治疗水平。方法选取2015年6月至2018年12月本院TFB儿童72例,全部接受支气管镜检查,总结TFB患儿临床表现及诊疗过程。结果患儿TFB的位置以支气管为主,右侧支气管46 例,占63.89%(46/72),左侧支气管15 例,占20.83%(15/72),其次为气管异物11 例,占15.28%(11/72)。另外,按照异物种类统计:①植物性:花生、瓜子、豆类、玉米等共63 例,占87.50%(63/72);②动物性:鱼刺、骨片等5 例,占6.94%(5/72);③矿物性:金属类、石子2 例,占2.78%(2/72);④化学性:塑料笔帽2 例,占2.78%(2/72)。所有患儿气促(或喘息)消失时间(2.79±0.81)d、咳嗽消失时间(2.58±0.69)d、湿啰音消失时间(3.01±0.98)d、住院时间(3.99±1.37)d。治疗后显效55 例,占76.39%(55/72),有效17 例,占23.61%(17/72),无效0 例,总有效率为100.00%。结论 在儿童气管支气管异物(TFB)中采取硬质支气管镜技术(RB),必须保证诊断的及时性与准确性,以免延误患儿的病情。在治疗中应尽量采取有效、可靠、安全舒适的手术方法,确保患儿的安全与健康,降低患儿的并发症发生率与病死率。

Objective To observe,evaluate,and analyze the application value of rigid bronchoscopy(RB)in children with tracheobronchial foreign bodies(TFB)in order to improve the diagnosis and treatment levels of TFB.Methods A total of 72 children with TFB in our hospital from June 2015 to December 2018 were selected.All children underwent bronchoscopy for clinical manifestations and diagnosis and treatment of TFB.Results The location of TFB in children was mainly bronchus,there were 46 cases of right bronchial foreign bodies,accounting for 63.89%(46/72),15 cases of left bronchial foreign bodies,accounting for 20.83%(15/72),followed by 11 cases of tracheal foreign bodies,accounting for 15.28%(11/72).In addition,according to the types of foreign bodies:①plant:peanuts,sunflower seeds,beans,corn,etc.,63 cases,accounting for 87.50%(63/72);②animal:5 cases including fishbone and bone slices,accounting for 6.94%(5/72);③mineral:metal,stone,2 cases,accounting for 2.78%(2/72);④chemical:plastic pen cap,2 cases,accounting for 2.78%(2/72).The time of shortness of breath(or wheezing)disappeared of all children was(2.79±0.81)d,the time of cough disappeared was(2.58±0.69)d,the time of wet rales disappeared was(3.01±0.98)d,and the hospital stay was(4.09±1.37)d.After treatment,55 cases were markedly effective,accounting for 76.39%(55/72),17 cases were effective,accounting for 23.61%(17/72),without ineffective case,and the total effective rate was 100.00%.Conclusions The use of rigid bronchoscopy(RB)in children with tracheobronchial foreign bodies(TFB)must ensure the timeliness and accuracy of the diagnosis,so as not to delay the illness of the children.In the treatment,effective,reliable,safe,and comfortable surgical methods should be taken as far as possible to ensure the safety and health of children,reduce the complications and mortality in children.