儿童气管支气管异物936例临床分析

doi:10.6040/j.issn.1671-7554.0.2022.1286

摘要/Abstract

摘要： 目的分析不同时期儿童气管支气管异物的临床特征、影像学检查、手术治疗情况及术后并发症的差异,探讨其临床诊疗新进展。方法选取2010年6月至2022年5月青岛大学附属烟台毓璜顶医院耳鼻咽喉头颈外科收治的儿童气管支气管异物患儿936例,根据入院时间分为两组:2010年6月至2016年5月为前期组(n=526)、2016年6月至2022年5月为后期组(n=410)。回顾性分析两组患儿的年龄、性别、异物种类、就诊时间、胸部X线片/CT扫描检出率、手术治疗率、胸部X线片/CT扫描诊断正确率、异物嵌顿部位、异物位置变化及术后并发症,比较两组指标的差异。结果两组患儿的性别、年龄、异物种类、就诊时间、胸部X线片/CT扫描检出率、手术治疗率、胸部X线片/CT扫描诊断正确率、异物位置变化差异无统计学意义(P均>0.05);术中异物嵌顿部位及术后并发症差异有统计学意义(P=0.04,P=0.01)。多因素二分类Logistic 回归分析显示,与前期组比较,后期组异物嵌顿部位在左上支气管下降0.178倍、术后并发症中的肺炎下降0.423倍。结论儿童气管支气管异物是常见急危重症,及时就诊、正确诊断、尽早手术并且尽可能提高一次手术成功率是避免其术后并发症的关键。

关键词: 气管支气管异物, 儿童, 支气管镜, 手术

Abstract: Objective To analyze the differences in clinical characteristics, imaging examination results, surgical treatments and postoperative complications of tracheobronchial foreign body in children in different periods, and to explore the advances of clinical diagnosis and treatment. Methods A total of 936 children with tracheobronchial foreign body hospitalized in the Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University during June 2010 and May 2022 were enrolled. According to the admission time, they were divided into early group(admitted during June 2010 and May 2016, n=526)and late group(admitted during June 2016 and May 2022, n=410). The patients age, gender, type of foreign body, visit time, detection rate of chest X ray/CT scanning, surgical treatment rate, correct diagnostic rate of chest X-ray/CT scanning, incarceration site of foreign body, change of location of foreign body and postoperative complications were compared between the two groups. Results There were no significant differences between the two groups in patients age, gender, type of foreign body, visit time, detection rate of chest X-ray/CT scanning, surgical treatment rate, correct diagnostic rate of chest X-ray/CT scanning, and change of location of foreign body(P>0.05). There were statistically significant differences in the incarceration site of foreign body and postoperative complications(P=0.04, P=0.01). Multivariate binary Logistic regression analysis showed that in the late group, the incarceration site of foreign body in the left upper bronchus decreased by 0.178 times compared with that in the early group, and incidence of pneumonia decreased by 0.423 times. Conclusion Tracheobronchial foreign body in children is common, acute and severe. Timely treatment, correct diagnosis, early surgery and success rate of first-stage operation are key to avoid postoperative complications.

Key words: Tracheobronchial foreign body, Children, Bronchoscopy, Surgery

中图分类号:

R768.1

周加敏,仇静静,陈秀梅,宋西成,孙岩. 儿童气管支气管异物936例临床分析[J]. 山东大学学报 (医学版), 2023, 61(4): 71-76.

ZHOU Jiamin, QIU Jingjing, CHEN Xiumei, SONG Xicheng, SUN Yan. Clinical analysis of 936 cases of tracheobronchial foreign body in children[J]. Journal of Shandong University (Health Sciences), 2023, 61(4): 71-76.

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