复杂气管、支气管异物4例并文献复习

目的提高复杂气管、支气管异物的诊断与治愈率，减少并发症。方法对我科诊治的4例复杂气管、支气管异物患者资料，结合文献进行回顾性分析。结果2例因异物嵌顿需二次手术，但避免了开胸手术；1例双侧支气管异物因术中即时发现而避免了二次手术，1例上叶支气管异物予部分取出后1个月，自行咳出残余物。结论术前要有充分的准备；纤维支气管镜下异物取出术应用于3岁以上儿童为宜；气管、支气管异物患者是否常规进行CT检查，仍值得探讨；在明确异物情况下，可用力钳取；易脆异物，要注意多发性可能；急诊室应常规备有鳄鱼钳等简单器械，以利迅速取出嵌顿于声门的异物。

Complicated trachea or bronchus foreign bodies in 4 cases

ObjectiveTo improve the diagnosis and cure rate of complicated trachea or bronchus foreign bodies. MethodsThe clinical data of 4 cases of complicated trachea or bronchus foreign bodies from June 2004 to June 2007 were retrospectively analyzed. Results2 cases received rigid bronchoscopies two times because of foreign body inlaying but avoided thoracotomy. 1 case of pairs of side bronchi foreign bodies received one operation. 1 case of upper lobe bronchus foreign body was partly taken out, one month later its residue happened to be coughed out. ConclusionsWe should make a full preparation before the operations. The fiberoptic bronchoscopy for a foreign body should be suitable for children above 3 years old. Whether patients with trachea or bronchus foreign bodies should be carried on a routine CT inspection still deserves discussion. A define foreign body can be fetched hard. For the fragile foreign body, we should pay attention to possible multiple ones in the trachea or bronchi. Also there should be such simple apparatus as a crocodile clamp in the emergency room to rapidly remove foreign bodies inlaid in the glottis.