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山东大学学报 (医学版) ›› 2023, Vol. 61 ›› Issue (4): 71-76.doi: 10.6040/j.issn.1671-7554.0.2022.1286

• 临床医学 • 上一篇    下一篇

儿童气管支气管异物936例临床分析

周加敏1,2,3,仇静静1,2,3,陈秀梅1,2,3,宋西成1,2,3,孙岩1,2,3   

  1. 1.青岛大学附属烟台毓璜顶医院耳鼻咽喉头颈外科, 山东 烟台 264000;2.山东省耳鼻喉疾病临床医学研究中心, 山东 烟台 264000;3.烟台市耳鼻喉疾病重点实验室, 山东 烟台 264000
  • 发布日期:2023-04-11
  • 通讯作者: 孙岩. E-mail:entsunyan@126.com
  • 基金资助:
    山东省自然科学基金面上项目(ZR2021MH378);山东省老年医学会2021年度科技发展计划项目(LKJGG2021Z020);烟台市科技计划项目(2021MSGT046)

Clinical analysis of 936 cases of tracheobronchial foreign body in children

ZHOU Jiamin1,2,3, QIU Jingjing1,2,3, CHEN Xiumei1,2,3, SONG Xicheng1,2,3, SUN Yan1,2,3   

  1. 1. Department of Otolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai 264000, Shandong, China;
    2. Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai 264000, Shandong, China;
    3. Yantai Key Laboratory of Otorhinolaryngologic Diseases, Yantai 264000, Shandong, China
  • Published:2023-04-11

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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
[1] Ding G, Wu B, Vinturache A, et al. Tracheobronchial foreign body aspiration in children: a retrospective single-center cross-sectional study[J]. Medicine, 2020, 99(22): e20480. doi: 10.1097/MD.0000000000020480.
[2] Chen YC, Xian ZX, Han SH, et al. A first-aid fast track channel for rescuing critically ill children with airway foreign bodies: our clinical experience[J]. BMC Emergency Medicine, 2021, 21(1): 85. doi: 10.1186/s12873-021-00482-8.
[3] 严尚, 姜鹏, 曾楠, 等. 儿童气管支气管异物400例临床诊治分析[J]. 中国耳鼻咽喉头颈外科, 2022, 29(2): 119-122. YAN Shang, JIANG Peng, ZENG Nan, et al. Diagnosis and treatment of tracheaobronchial foreign body in 400 children[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2022, 29(2): 119-122.
[4] 陈蔚华, 张凯扬, 郑晓彬. 小儿喉、气管、支气管异物221例临床分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 111-115. CHEN Weihua, ZHANG Kaiyang, ZHENG Xiaobin. Foreign bodies in the throat and bronchi of children: a report of 221 cases[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(5): 111-115.
[5] 赵斯君, 李赟. 儿童气管支气管异物诊治中应关注的问题[J]. 中国耳鼻咽喉颅底外科杂志, 2022, 28(3): 1-5. ZHAO Sijun, LI Yun. The issues about the diagnosis and treatment of tracheobronchial foreign body aspiration in children[J]. Chinese Journal of Otorhinolaryngology-Skull Base Surgery, 2022, 28(3): 1-5.
[6] Yan S, Jiang P, Chen G, et al. Characteristics and treatment of pediatric tracheobronchial foreign bodies: a retrospective analysis of 715 cases[J]. Med Sci Monit, 2022, 28: e937928. doi: 10.12659/MSM.937928
[7] Samra S, Schroeder JWJr, Valika T, et al. Tracheotomy for difficult airway foreign bodies in children[J]. Otolaryngol Head Neck Surg, 2018, 158(6): 1148-1149.
[8] Naara S, Vainer I, Amit M, et al. Foreign body aspiration in infants and older children: a comparative study[J]. Ear Nose Throat J, 2020, 99(1): 47-51.
[9] Chaudhary N, Shrestha S, Kurmi OP. A child with a foreign body in bronchus misdiagnosed as asthma[J]. Clin Case Rep, 2020, 8(12): 2409-2413.
[10] 宾翔, 陈峋, 刘静, 等. 气管支气管异物15年病例回顾[J]. 中国耳鼻咽喉颅底外科杂志, 2022, 28(5): 63-68. BIN Xiang, CHEN Jing, LIU Jing, et al. Tracheobronchial foreign bodies: a 15 year, review[J] Chinese Journal of Otorhinolaryngology-Skull Base Surgery, 2022, 28(5): 63-68.
[11] Gan W, Xiao N, Feng Y, et al. Clinical analysis of tracheobronchial foreign body aspiration in children: a focus on external and intrinsic factors[J]. BMC Surg, 2021, 21(1): 108. doi: 10.1186/s12893-021-01089-3.
[12] 郝丽丽, 夏忠芳, 王智楠, 等. 小儿双侧支气管异物40例临床特点及治疗分析[J]. 中国眼耳鼻喉科杂志, 2017, 17(2): 119-122. HAO Lili, XIA Zhongfang, WANG Zhinan, et al. Clinical characteristics and treatment analysis of 40 cases of bilateral bronchial foreign bodies in children[J]. Chinese Journal of Ophthalmology and Otorhinolaryngology, 2017, 17(2): 119-122.
[13] Antón-Pacheco JL, Martín-Alelú R, López M, et al. Foreign body aspiration in children: Treatment timing and related complications[J]. Int J Pediatr Otorhinolaryngol, 2021, 144: 110690. doi: 10.1016/j.ijporl.2021.110690.
[14] 陈莉莉, 吴谨准, 陈先睿, 等. 儿童气管支气管异物临床特征分析(附228例报告)[J]. 中国实用儿科杂志, 2019, 34(9): 785-788. CHEN Lili, WU Jinzhun, CHEN Xianrui, et al. Clinical characteristics of tracheobronchial foreign body in children:a report of 228 cases[J]. Chinese Journal of Practical Pediatrics, 2019, 34(9): 785-788.
[15] Wang L, Zhang L, Li C, et al. Characteristics of correct diagnosis versus misdiagnosis of paediatric tracheobronchial foreign body[J]. Paediatr Child Health, 2021, 26(1): e6-e10.
[16] Reyad HM, El-Deeb ME, Abbas AM, et al. Foreign body aspiration in egyptian children clinical, radiological and bronchoscopic findings[J]. J Multidiscip Healthc, 2021, 14: 2299-2305. doi: 10.2147/JMDH.S326967.
[17] 刘洪根, 陈晓琪, 李继云. 儿童气管支气管异物的病例特征的回顾性分析[J]. 临床肺科杂志, 2021, 26(12): 1838-1842. LIU Honggen, CHEN Xiaoqi, LI Jiyun. Retrospective analysis on the characteristics of children with tracheobronchial foreign body[J]. Journal of Clinical Pulmonary Medicine, 2021, 26(12): 1838-1842.
[18] 麻李思雨, 李王平, 潘蕾, 等. 10年气管、支气管异物诊治回顾性分析[J]. 中华肺部疾病杂志, 2019, 12(3): 275-280. MALI Siyu, LI Wangping, PAN Lei, et al. Retrospective analysis on treatment of tracheal or bronchial foreign bodies in recent 10 years[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2019, 12(3): 275-280.
[19] Aubanel S, Izaute G, Gariel C, et al. Oxygen desaturation and time burden during tracheobronchial endoscopy for suspected foreign body in toddlers[J]. J Clin Monit Comput, 2021, 35(5): 1077-1084.
[20] 王家晨, 郑睿, 徐学海. 儿童气管异物致气管食管瘘1例[J]. 中国耳鼻咽喉颅底外科杂志, 2022, 28(3): 34-35.
[21] Wu Y, Dai J, Wang G, et al. Delayed diagnosis and surgical treatment of bronchial foreign body in children[J]. J Pediatr Surg, 2020, 55(9): 1860-1865.
[22] Brkic F, Umihanic S, Altumbabic H, et al. Death as a consequence of foreign body aspiration in children[J]. Med Arch, 2018, 72(3): 220-223.
[23] 姜岚, 韩富根, 许莹, 等. 儿童气管支气管异物取出术发生低氧血症的相关因素分析[J]. 中国耳鼻咽喉颅底外科杂志, 2022, 28(3): 6-10. JIANG Lan, HAN Fugen, XU Ying, et al. Factors associated with hypoxemia in tracheobronchial foreign body removal in children[J]. Chinese Journal of Otorhinolaryngology-Skull Base Surgery, 2022, 28(3): 6-10.
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