摘要
目的 探讨可弯曲支气管镜联合硬镜鞘管治疗儿童气道异物的有效性、安全性。方法 收集2019年1月-2022年12月在我院经可弯曲支气管镜联合硬镜鞘管治疗的61例儿童气道异物患者,分析上述患儿的首发症状、气道异物的影像学表现、影响不同类型气道异物的取出因素。结果 儿童气道异物最常见的首发症状为刺激性干咳,占所有临床表现的55.29%;异物位于气管的患儿为8例(13.11%),右侧支气管系统异物为34例(55.74%),左侧支气管系统异物为19例(31.15%);年龄、异物长径、取异物的器械数量、异物取出时间与异物类型有关,差异具有统计学意义(P<0.05);年龄≥6岁的儿童发生非食物类异物的风险较高,年龄≤3岁的儿童发生食物类异物的风险较高;异物长径<10 mm的发生非食物类异物的可能性较高,异物长径≥10 mm的发生食物类异物的可能性较高;发生食物类异物,使用异物取出方式1种工具的概率较高;发生非食物类异物,使用异物取出方式≥2种工具的概率较高,发生食物类异物时异物取出时间<5 min概率较高,发生非食物类异物时异物取出时间≥5 min概率较高;在取出异物过程中出1例(1.6%)患儿在拔出硬镜鞘管后出现喘息症状,未出现患儿死亡。结论 可弯曲支气管镜联合硬镜鞘管治疗儿童气道异物的有效性及安全性较高,具有一定的临床推广价值。
Objective To explore the effectiveness and safety of flexible bronchoscopy combined with a rigid sheath tube in treatment of pediatric airway foreign bodies.Methods It collected the clinical data of 61 cases of pediatric airway foreign body patients treated with flexible bronchoscopy combined with a rigid sheath tube in our hospital from January 2019 to December 2022.It analyzed the initial symptoms of these patients,the radiological manifestations of airway foreign bodies,and factors affecting the removal of different types of airway foreign bodies.Results The most common initial symptom of pediatric airway foreign bodies was irritative dry cough,accounting for 55.29%of all clinical presentations.In this study,8 cases(13.11%)had foreign bodies located in trachea,34 cases(55.74%)in the right bronchial system,and 19 cases(31.15%)in the left bronchial system.Age,length of foreign body,number of instruments used for removal,and time of foreign body removal were associated with the type of foreign body,and the differences were statistically significant(P<0.05).Children aged≥6 years had a higher risk of non-food foreign bodies,while children aged≤3 years had a higher risk of food foreign bodies.The likelihood of non-food foreign bodies was higher when the length of the foreign body was<10 mm,and the likelihood of food foreign bodies was higher when the length of the foreign body was≥10 mm.The probability of using one tool for foreign body removal was higher for food foreign bodies,while the probability of using two or more tools for non-food foreign bodies was higher.The probability of foreign body removal within<5 minutes was higher for food foreign bodies,while the probability of foreign body removal within≥5 minutes was higher for non-food foreign bodies.During the removal process,1 case(1.6%)experienced wheezing symptoms after pulling out the rigid sheath tube,and no death occurred.Conclusion The combination of flexible bronchoscopy and a rigid sheath tube in treatment of pediatric airway foreign bodies is highly effective and safe,with potential clinical applicability.
作者
高亭
赵佩文
何小鹏
李娟芝
原淑莉
GAO Ting;ZHAO Peiwen;HE Xiaopeng;LI Juanzhi;YUAN Shuli(Respiratory and Critical Care Medicine Department,Xianyang Central Hospital,Xianyang,Shaanxi 712099,China)
出处
《临床肺科杂志》
2024年第8期1162-1166,共5页
Journal of Clinical Pulmonary Medicine
基金
陕西中医药大学校级课题(No.2021FS06)。
关键词
气管支气管异物
可弯曲支气管镜
硬镜外鞘管
儿童
tracheobronchial foreign body
flexible bronchoscopy
rigid sheath tube
children
