小儿气管、支气管异物的诊治体会

目的：提高小儿气管、支气管异物的诊断及治疗水平，以进一步减少或避免并发症的发生．方法：对我院１９９７年１月～２００１年２月收治的气管、支气管异物３１０例进行回顾性分析．结果：除２例自行咳出外，其余均在全麻下行支气管镜检顺利取出，异物位于气管内 ８３例，支气管 ２２７例（其中右例 １２２例，左侧 ９９例，双侧６例）．术前及术中气管切开８例．入院时并发气胸、纵隔及皮下气肿５例，术中窒息６例，术后喉头水肿５例，无死亡．结论：气管、支气管异物多发生于３岁以下的小儿，临床症状常较重，易误诊．诊断主要依靠病史及Ｘ线检查．早期诊断、恰当的手术时机、良好的麻醉技术是顺利取出异物、减少并发症的关键．

Experience on Diagnosis and Treatment of Foreign Body in Children Trachea and Bronchus

Objective: To improve the results of tracheobronchial foreign body in children on diagnosis and treatment. Methods: Retrospective study was carried out on 310 children with tracheobronchial foreign body January 1997 to February 2001. Results: The foreign bodies were in the trachea in 83 cases and in bronchus in 227 cases. Except spontaneous expectoration of inhaled foreign body occurred in 2 cases. Total 308 foreign bodies were removed by bronchoscopic technique and tracheostomy was performed in 8 cases. Pneumomediastimun-pneumothorax occurred in 5 cases before bronchoscopy, choking occurred in 6 cases during operation and laryngeal edema occurred in 5 cases postoperatively. Conclusion: Tracheobronchial foreign bodies are most commonly occurred in children under the age of 3 years. The clinical presentation is often serious and the diagnosis is easy to be ignored. History of foreign body aspiration and radiological examination have important value in diagnosis. Proper indications of operation, better anesthetic techniques and, necessary bronchotomy have been proven to be satisfactory.