非洲儿童气管支气管异物的临床特点分析

目的探讨对非洲儿童气管、支气管异物的诊断和治疗方法。方法回顾性分析笔者在非洲尼日尔共和国尼亚美国家医院工作期间收治的儿童气管、支气管异物90例的临床资料及其诊治经过。结果 81例患儿在全麻下行硬支气管镜检查并将异物成功取出,痊愈出院;1例在就诊时因窒息而死亡;两例手提脚头朝下拍打背部,咳出异物;两例麻醉后因无手术器械而放弃手术;两例插管麻醉意外死亡;两例转外科开胸手术治疗。结论非洲儿童气管、支气管异物的诊治因地域、国情具有特殊性,异物多为中空型玩具,呼吸困难的情况少,且症状轻,诊断主要依靠病史,应用硬气管镜诊治,可代替气管导管,既可手术也可麻醉和通气、缩短手术时间、提高手术安全性,是诊治非洲(包括我国贫困地区)儿童气管、支气管异物的首选方法。

Treatment for Trachea and Bronchial Foreign Body of Children in Africa

Objective To study the diagnosis and treatment of trachea and bronchial foreign body in African children.Methods We retrospectively reviewed the data of 90 patients who were diagnosed as tracheabronchial foreign body in the pediatric hospital in Niamey,Niger during our aid medical work there and analyzed the diagnosis and treatment process.Results Eighty-one patients received rigid bronchoscop under general anaesthesia to have the foreign bodies removed successfully and finally discharged from the hospital.One patient died of asphyxiation during diagnostic examination;two cases coughed out the foreign bodies with their head down and being pat the backs;two cases failed to receive the operation due to lack of surgical equipments after anesthesia;two cases died of general anesthesia accident,and two were transferred to the department of thoracic surgery to receive thoracotomy.Conclusion The diagnosis and treatment for trachea and bronchial foreign body of African children was special due to different countries and different economic conditions.The foreign bodies were mostly hollow-type toys,therefore,this disease in Africa had different clinical features:few dyspnea and light symptoms.The diagnosis and treatment mainly depended on case history and rigid bronchscopy instead of tracheal catheter.Rigid bronchscopy,which can be utilized not only for operation but also for anesthesia and ventilation,may shorten operation time and improve safety of operation and is the preferred treatment method for trachea and bronchial foreign body of children in Africa and poor areas in our country as well.