气管支气管异物236例的临床诊疗分析

Clinical diagnosis and treatment of 236 cases of tracheobronchial foreign body

目的分析气管支气管异物患者的临床特征,并分析不同的麻醉方式对术中并发症影响的差异。方法回顾性分析河南科技大学第一附属医院2016年至2019年收治的236例气管支气管异物患者的临床诊疗资料,根据年龄分成<3岁组、3~14岁组、>14岁组;按发病至手术的时间分A组(发病1 d内)、B组(发病1 d至1周)、C组(>1周);按手术时的麻醉方式不同,分为表面麻醉组和全身麻醉组。结果236例中,<3岁组发病例数193例,植物性异物158例;A、B、C三组异物在气道内的存留时间和肺部并发症的发生率比较差异有统计学意义(χ^(2)=16.114,P=0.000);表面麻醉和全身麻醉术后并发症的发生率比较差异有统计学意义(χ^(2)=18.538,P=0.000)。结论3岁以内是气管支气管异物的高发年龄,植物性异物是致病的主要种类;异物在气道的存留时间和肺部并发症的发生率呈正相关;全身麻醉下气管异物取出术引起的术后并发症较低,手术更安全。

【Objective】To analyze the clinical characteristics of patients with tracheobronchial foreign body and reduce the incidence of the disease and surgical complications.【Methods】The clinical diagnosis and treatment data of 236 patients with tracheobronchial foreign body admitted to our department from 2016 to 2019 were analyzed.They were divided into younger than 3 years old goup,3-14 years old group and over 14 years old group according to their ages.According to the time from onset to operation,the patients were divided into group A(within 1 day of onset),group B(more than 1 day and less than 1 week),and group C(more than 1 week).According to the operation of different anesthesia,they were divided into surface anesthesia group and general anesthesia group.【Results】Among the 236 cases,193 cases were younger than 3 years old,and 158 cases were of plant foreign body.The duration of foreign body in the airway and the incidence of pulmonary complications were significantly different among group A,B,C(χ^(2)=16.114,P=0.000).The incidence of postoperative complications of surface anaesthesia and general anaesthesia was significantly different(χ^(2)=18.538,P=0.000).【Conclusion】There is high incidence of tracheobronchial foreign body in children under 3 years old.The duration of foreign body in the airway was positively correlated with the incidence of pulmonary complications.The postoperative complications caused by tracheal foreign body removal under general anesthesia are lower and the operation is safer.