肺段支气管异物八例治疗分析

目的探讨肺段支气管异物的发病原因、临床表现和治疗方法。方法发生于肺段的支气管异物一般较小且病史较长，临床症状隐匿或表现为肺部反复感染、肺不张和咳血等，对8例肺段支气管异物患者实施气管镜检查，辅助应用气管内镜，观察异物的形态、位置及与气管壁的关系，并取异物；其中2例利用X线透视机对金属异物进行定位。结果8例肺段支气管异物中6例一次成功取出，术后无气胸、纵膈气肿等并发症。2例失败，1例异物是大头针，病史1年；另1例异物是小笔帽，病史24年；转胸科实施开胸手术顺利取出。结论对于异物较小、临床症状复杂的肺段支气管异物，要做详细的术前检查，术中要选择应用适宜的异物钳、气管内镜等，必要时在X线透视机下操作，并注意防止气胸等并发症的发生。

Eight cases report of segmental bronchi foreign body

Objective To review the clinical features and the treatment of segmental bronchi foreign bodies cases. Methods Rigid hronchoscope and endoscope were applied to all 8 cases under general anesthesia. The foreign bodies shape and position were well evaluated under direct view, and the metal ones were located with X ray. Results Generally, the foreign bodies in segmental bronchi are small size and have a long history, the symptoms are non typical and may be accompanied with recurrent lung infection and haemoptysis. The foreign bodies were successfully removed in 6 patients with bronchoscopy, and the foreign bodies in other 2 cases were removed with thoracotomy. No complications occurred in all cases. Condusions For the segmental bronchi foreign body cases, the non typical history should be well reviewed and a detailed investigation should be performed. Suitable surgical instruments should be well selected so to get higher success rate and effectively prevent potential compilations.