小儿气管支气管异物721例的诊断与治疗

目的:总结小儿气管支气管异物的诊断治疗,有效降低并发症及死亡率.方法:回顾分析我院1997年1月～2007年10月间收治的721例小儿气管支气管异物诊断及治疗的临床资料.结果:721例患儿中,男471例(65.3%),女250例(34.7%).35例因病情危重直接镜检,686例均作胸透及胸片或CT检查.明确有呼吸道异物的721例.主气管和(或)双侧支气管异物66例,位于右主支气管内371例,位于左主支气管内284例.已经有肺不张42例,其中11例肺实变,经支气管内灌洗吸痰治疗而复张,3例合并支气管扩张,异物取出后经保守治疗无好转行肺叶切除,2例呼吸循环衰竭死亡(镜检有异物,未取),716例1次镜检成功取出异物,占99.3%,3例行2次镜检取出异物.常见异物为花生、瓜子及豆类.结论:对小儿气管、支气管异物及时准确的诊断、治疗,可避免延误病情,有效的降低并发症及死亡率.

Diagnosis and treatment of 721 children with tracheobronchial foreign body

Objective: To summarize the diagnosis and treatment of pediatric tracheobronchial foreign body, and to reduce its complication and mortality. Methods: Retrospective analysis was carried out among the clinical data of the diagnosis and treatment of 721 cases of tracheobronchial foreign body from 1997 to 2007 in our hospital. Results: In 721 patients, 471 ( 65.3% ) were males and the other ( 34.7% ) were females. 35 patients in critical condition underwent directly bronchoscopy. 686 patients had undergone chest roentgenoscopy and X-ray film or CT scanning. 721 cases of tracheobranchial foreign body were identified, with 66 cases in the trachea or both bronchus,371 cases in right main bronchus,and 284 cases in left main bronchus. There had been pulmonary closure in 42 cases, 11 of which with consolidation of lung were healed by endotracheal irrigation, 3 of which with bronchiectasis were not improved after the removed of the foreign body by conservative treatment and bad lobes of lung had to resected.2 patients died of respiratory and circulatory failure.Fist time brochoscopy and removed of foreign body were achieved in 716 cases (99.3% ),which second time were brochoscopy and removed of foreign body was 3 cases.Most of the foreign bodies were peanut, melon seeds and beans. Conclusions Pediatric tracheobronchial foreign body was rapidly diagnosed and treated.The delay of pathogenetic condition can be avoided and the incidence of complication and mortality cut down effectively.