儿童气管支气管异物长期滞留的临床特点分析

Clinical Study of Children with Long-Term Tracheobronchial Foreign Body

目的:初步探讨儿童长期滞留气管支气管异物病例的特点,分析其下呼吸道分泌物细菌学种类,为临床诊治提供诊疗经验。方法:回顾性分析100例长期滞留气管支气管异物的病例特点,并对术中所取呼吸道分泌物进行细菌培养实验。结果:100例患者常见的并发症包括肺气肿、肺不张、肺炎及支气管炎,平均住院日为5天。胸部CT发现异物阳性率为96%,多层螺旋CT三维重建发现异物的阳性率接近100%。100例患儿下呼吸道分泌物标本细菌菌种主要为金黄色葡萄球菌、肺炎克雷白杆菌、白假丝酵母菌、鲍氏不动杆菌、阴沟肠杆菌;咽拭子标本细菌菌种主要有金黄色葡萄球菌、肺炎克雷白杆菌。结论:对于儿童长期反复发生的呼吸系统疾病,要排除有关长期滞留气管支气管异物的可能。长期滞留气管支气管异物的患儿肺部感染率明显提升,患者平均住院日明显提高。胸部CT和多层螺旋CT三维重建发现呼吸道异物的阳性率高,在可疑气管支气管异物诊断中有重要的应用价值。异物长期滞留可导致肺部常见菌种的感染。

Objective: To investigate the clinical characteristics of long term tracheobronchial foreign bodies, summarize the discharge types of bacteriology and provide diagnostic and therapeutic experience. Methods: Data of 100 cases with suspected long term tracheobronchial foreign bodies were ana-lyzed, and bacteriology secretion of respiratory tract secretion from 100 patients was analyzed. Result: Among the 100 cases, the patient may suffer from emphysema, atelectasis, pneumonia, and bronchitis. The average days of hospitalization were 5. The positive rate of foreign body in chest CT was 96% and that in 3D reconstruction of multislice spiral CT was close to 100%. What can be substrated in lower respiratory tract secretion in children with bronchial foreign body, including Staphylococcus aureus, Klebsiella pneumoniae, Candida albicans, Acinetobacter baumannii, Enter-obacter cloacae, and in swab specimens Staphylococcus aureus and Klebsiella pneumoniae was in-cluded. Conclusion: For the long-term recurrent respiratory diseases in children, the possibility of long term retention of the foreign body of the trachea and bronchus should be excluded. The lung infection rate of children with long-term retention of tracheobronchial foreign bodies and the av-erage hospital stay was significantly increased. Chest CT and chest CT 3D reconstruction technology with high effective rate in the diagnosis have important application value in the diagnosis of suspected tracheobronchial foreign body. The long-term retention of foreign body can deduce to infection of common bacteria in the lungs.