心影吸气性增大在儿童气道阻塞中的意义

Inspiratory cardiac broadening in airway obstruction of children

目的：探讨X线透视心影吸气性增大在儿童气道阻塞中的应用价值和注意事项。方法：透视观察临床拟诊气管和复合部位异物儿童45例，以内窥镜为标准评价透视诊断的准确性。同期透视哮喘发作儿童和哭吵儿童各40例作对照。结果：气管和复合部位异物阳性29例（真24、假5），阴性16例（真2、假14）。透视诊断准确性为57.8%，敏感性为63.2%，特异性为28.6%，阳性预测值为82.6%。哮喘组和哭吵组心影吸气性增大为60%和100%。结论：透视对气管和复合部位异物的诊断具较高敏感性和低特异性；对气道阻塞征象应注意鉴别诊断特别是哭吵现象。

Objective: To explore the value and attentions of inspiratory cardiac broadening in airway obstruction of the children. Methods: To evaluate the accuracy of fluoroscopy, fluoroscopy and endoscopy were performed in 45 cases of suspicious tracheal and multiple located foreign bodies. To eveluate the cardiac broadening during inspiration,40 asthmatic children and 40 crying healthy children had fluoroscopy as well. Results: 29 cases were positive (true 24,false 5) and 16 cases were negative (true 2,false 14) in 45 cases of the suspicious tracheal and multiple located foreign bodies. The accuracy was 57.8%,sensitivity was 63.2%, specificity was 28.6% and positive predictive value was 82.6% in fluoroscopy. Inspiratory cardiac broadening was 60% in asthmatic children and 100% in crying healthy children. Conclusion:Fluoroscopy has a higher sensitivity and a low specificity for tracheal and multiple located foreign body aspiration,and the attention must be paid to avoid deep cry during fluoroscopy, in estimating the inspiratory cardiac broadening.