儿内科小儿气管异物的误诊原因及处理对策

目的分析儿内科小儿气管异物的误诊原因并总结小儿气管异物的应急处理措施。方法对于2008年10月至2011年6月在我院儿内科进行就诊治疗的53例小儿气管异物患者的临床资料进行回顾性分析,对其误诊的疾病及原因进行统计分析。结果 53例小儿气管异物患者均因咳嗽、多痰、发热及呼吸急促等表现而就诊于我院儿内科;患者的病程在10d~2年,来院时患者均没有异物吸入史;患者大多为阵发性咳嗽,其中有17例患者伴有气喘,有24例患者伴有发热,仅有4例患者出现紫绀表现及呼吸困难表现。所有患者的肺部均可闻及湿性啰音,其中有7例患者的单侧呼吸音降低;经X线检查,其中有27例患者的肺部纹理增加,并出现了片状阴影;16例患者的胸片未见异常;53例患者中有14例患者被误诊为支气管炎,有6例患者被误诊为肺炎,有3例患者被误诊为急性喉炎。所有患者在我院确诊后,进行手术治疗后均痊愈,住院时间在1~8d。结论气管异物吸入是小儿常见的急症,临床上应该积极了解患者的病史,进行正确的影像学诊断,降低误诊率,对患者早期手术治疗,促进其恢复。

The Children Medicine Pediatric Airway Foreign Bodies Misdiagnosed Causes and Management

Objective Analysis of children misdiagnosis of Internal Medicine Pediatric airway foreign bodies, and summarizes the emergency measures of the pediatric airway foreign bodies. Methods Retrospective analysis of the clinical data for October 2008-June 2011 in our hospital children .medicine diagnosis and treatment of 53 cases of pediatric airway foreign bodies patients, statistical analysis of the disease and the reasons for its misdiagnosis. Results 53 cases of pediatric airway foreign bodies patients because of cough, sputum, fever and shortness of breath, such as performance and treatment in our hospital children medicine; course of patients to the hospital in 10 days to 2 years, patients bad no history of foreign body aspiration; most patients paroxysmal cough, 17 patients with asthma, 24 patients with fever, only 4 patients had cyanosis performance and dyspnea. All the patient＇s lungs can smell and moist rales, including seven patients with unilateral reduced breath sounds; through the X-ray examination, including 27 patients, the lining of the lungs and patchy shadows; 16 cases patients with no abnormal chest X-ray; 53 patients, 14 patients were misdiagnosed as bronchitis, 6 patients were misdiagnosed as pneumonia, 3 patients were misdiagnosed as acute laryngitis. All patients diagnosed in our hospital for surgical treatment were cured after a hospital stay of 1-8 days. Conclusion Tracheal foreign body inhalation is a common pediatric emergencies, should actively understand the patient＇s clinical history, correct imaging diagnosis and reduce the rate of misdiagnosis, surgical treatment of patients with early, to promote their recovery.