气管支气管异物1368例临床分析

目的探讨呼吸道异物的特点及有效治疗方法,以降低其误诊、死亡率,减少并发症发生。方法回顾性分析1368例气管支气管异物患者病历资料,其中全身麻醉下经支气管镜取出异物1334例,无麻下经支气管镜20例,经气管切开6例,开胸8例。结果静脉复合麻醉及无麻下呼吸道异物取出1365例。1次手术成功取出1345例,2次6例;术后并发喉水肿25例,窒息死亡3例,死亡率0.21%。结论提高对气管支气管异物的认识及诊断水平是降低误诊率的关键,静脉复合麻醉配合咽喉气管黏膜表面麻醉效果较为理想。尽量在硬管支气管镜下取出异物,但有些行气管切开及开胸仍有必要。

Tracheobronchial foreign bodies in 1368 cases

Objective: To investigate the characteristics of tracheobronchial foreign bodies and effective methods for them so as to decrease complications and mortality.Methods The clinical data of 1 368 cases were retrospectively analyzed.Of them 1 334 cases had the foreign bodies taken out by bronchoscopy under general anesthesia,20 cases by bronchoscopy without anesthesia,6 by tracheotomy and 8 by thoracotomy.Results 1 365 cases had the foreign bodies taken out,and 1 345 cases were successfully operated on one time and 6 cases two times.After the operations,25 cases had edema of the larynx and 2 died of asphyxia.Conclusion Total intravenous anesthesia combined with surface anesthesia of the respiratory tract mucosa is the ideal anesthesia method for taking out foreign bodies in the respiratory tract by bronchoscopy.In some cases,tracheotomy and thoracotomy are needed.