儿童支气管异物147例临床诊治分析

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英文篇名：Clinical diagnosis and treatment of bronchial foreign bodies in 147 children 作者：陈善佳 ; 顾浩翔 ; 陆敏 ; 吴蓓蓉 ; 唐容 英文作者：CHEN Shanjia;GU Haoxiang;LU Min;WU Beirong;TANG Rong;Department of Pediatric Respiratory, Shanghai Children's Hospital, Shanghai Jiao Tong University; 关键词：支气管异物 ; 支气管镜 ; 儿童 英文关键词：bronchial foreign body;;bronchoscope;;child 中文刊名：LCAK 英文刊名：Journal of Clinical Pediatrics 机构：上海市儿童医院上海交通大学附属儿童医院呼吸科; 出版日期：2019-01-15 出版单位：临床儿科杂志 年：2019 期：v.37 基金：上海市申康临床科技创新项目(No.SHDC12016215) 语种：中文; 页：LCAK201901010 页数：4 CN：01 ISSN：31-1377/R 分类号：32-35

摘要

目的分析儿童支气管异物的临床特点。方法回顾分析2014-2016年间收治的147例外源性支气管异物患儿的临床资料,并对硬质支气管镜、软式支气管镜取异物的应用进行比较。结果 147例患儿均由胸部CT、胸透或呼吸内镜诊断为支气管异物,其中男104例、女43例,1～3岁幼儿占87.8%。支气管异物种类以坚果类食物最为多见。常见并发症依次为支气管黏膜肉芽组织增生88例(59.86%)、肺炎56例(38.1%)、肺不张15例(10.2%)、呼吸衰竭14例(9.52%),支气管扩张4例(2.72%)。141例经呼吸内镜取出异物,其中106例(72.11%)为软式支气管镜,一次性成功取出者100例(94.34%);35例(23.81%)为硬质支气管镜,一次性成功取出者28例(80.0%)。结论儿童支气管异物以男性幼儿居多,软式支气管镜与硬质支气管镜均可取出儿童外源性下呼吸道异物。
        Objective To explore the clinical characteristics of bronchial foreign bodies in children. Method The clinical data of 147 children with exogenous bronchial foreign body admitted between 2014 and 2016 were retrospectively analyzed, and the applications of rigid bronchoscopy and flexible bronchoscopy for foreign body extraction were compared. Results All 147 cases were diagnosed with bronchial foreign bodies by chest CT, chest X-ray or respiratory endoscopy. In these cases(104 boys and 43 girls), 87.8% of whom were aged 1-3 years, the most common types of bronchial foreign body were nuts. The common complications were bronchial mucosal granulation tissue hyperplasia(88 cases, 59.86%), pneumonia(56 cases, 38.1%), atelectasis(15 cases, 10.2%), respiratory failure(14 cases, 9.52%) and bronchiectasis(4 cases, 2.72%) respectively. The foreign bodies were removed by soft bronchoscopy in 106 cases which were successfully removed at one time in 100 cases. Respiratory endoscopy was undergone in 141 cases to remove foreign bodies, and flexible bronchoscope was applied in 106(72.11%) cases and foreign bodies were successfully removed in first attempt in 100 cases(94.34%). Rigid bronchoscope was used in 35 cases(23.81%) and foreign bodies were successfully removed in first attempt in 28 cases(80.0%). Conclusion The majority of children with bronchial foreign body are male. Both flexible and rigid bronchoscopes can remove exogenous foreign bodies in the lower respiratory tract.

引文

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