摘要
目的探讨儿童呼吸道异物的发生情况及影像学表现,为儿童呼吸道异物危害的临床诊治与预防提供依据。方法回顾性分析2019年1月1日至2021年4月30日期间34例经影像及临床诊断为呼吸道异物患儿的临床资料,包括异物种类、就诊原因、治疗、影像学表现及预后等进行描述性分析。结果34例患儿中,男女性别比为2.09∶1,患病年龄以1~3岁为主,占总患儿的73.53%。79.41%的患儿有明确异物吸入史,21.59%则异物吸入史不详。患儿总就诊前病程为1小时至1月余,平均病程为2.85天。呼吸道异物的类型包括植物性可食性类23例(67%),其中以花生米为主,共14例(41%);动物性可食性类2例(6%);玩具类4例(12%);药物类1例(3%);其他不明物品类4例(12%)。经纤维支气管镜或硬支气管镜取出异物32例,其中主支气管异物2例,右侧支气管异物17例,左侧支气管异物13例。并发症主要以合并阻塞性肺气肿为主,其次是肺不张等。胸部CT提示,32例(94.12%)患儿在相应的异物的位置见条状、斑片状、不规则状密度增高影,部分边缘欠清;19例(55.88%)相应肺叶、段出现含气不全或含气过度;8例(23.53%)患儿肺部可见斑片状炎性渗出。结论儿童呼吸道异物好发于男性,且以三岁以下儿童多见,大部分有明确的异物吸入史。放射影像学,特别是CT检查及气道三维重建可快速提供准确的诊断依据,及时诊断和治疗是改善预后效果的关键。
Objective To investigate the prevalence and imaging findings of foreign bodies in the respiratory tract of children,and to strengthen the diagnosis,treatment and prevention of respiratory tract in children.Methods Medical records from 25 patients diagnosed with foreign bodies in the digestive tract were retrospectively analysed.Descriptive analysis were conducted to evaluate the data such as the type of foreign body,the cause of visit,treatment,imaging findings and prognosis.Results Among the 34 children,the sex ratio was 2.09:1,and the age of the patients was mainly 1 to 3 years old,accounting for 73.53%of the total children.79.41%of the children had a clear history of foreign body aspiration,while 21.59%had an unknown history of foreign body aspiration.The total duration of illness before consultation ranged from 1 h to more than 1 month,with a mean duration of 2.85 days.The types of foreign bodies in the respiratory tract included 23(67%)cases in the plant-based edible category,mainly peanut rice,with 14(41%)cases;and 2(6%)cases in the animal-based edible category;4(12%)cases in the toy category;1(3%)case in the drug category;and 4(12%)cases in the other unidentified items category.Foreign bodies were removed by fiberoptic bronchoscopy or rigid bronchoscopy in 32 cases,including 2 cases of main bronchial foreign bodies,17 cases of right bronchial foreign bodies and 13 cases of left bronchial foreign bodies.Complications were mainly combined with obstructive emphysema,followed by pulmonary atelectasis.The chest CT showed that 32(94.12%)children had striated,patchy or irregular densities in the location of the corresponding foreign body,and some of the edges were not clear;19(55.88%)children had incomplete or excessive air inclusion in the corresponding lobe or segment;8(23.53%)children had patchy inflammatory exudation in the lung.Conclusions Foreign bodies in the respiratory tract in children are more common in males and in children under three years of age,most of whom have a clear history of foreign body aspiration.Radiological imaging,especially CT examinations and three-dimensional airway reconstruction provied a rapid and accurate diagnosis.Timely diagnosis and treatment are key to improving prognostic outcomes.
作者
李伟佳
郑文斌
LI Wei-jia;ZHENG Wen-bin(The Second Affiliated Hospital of Shantou University Medical College,Shantou 515041,China)
出处
《伤害医学（电子版）》
2021年第3期32-37,共6页
Injury Medicine(Electronic Edition)
基金
广东省临床教学改革研究项目立项(2018JD058)
高水平大学建设计划临床医学重点建设学科专项资金。
关键词
儿童
呼吸道
异物
影像学表现
children
respiratory tract
foreign body
imaging manifestations
