儿童气管支气管异物84例临床分析

发布时间：2018-04-09 13:59

本文选题：气管支气管异物　切入点：儿童　出处：《中国实用儿科杂志》2017年06期

【摘要】：目的探讨儿童气管支气管异物的临床特征。方法回顾性分析天津市儿童医院2011年6月至2016年6月行支气管镜诊断和治疗的84例气管支气管异物患儿的一般情况、吸入史、病程、异物种类、异物滞留部位、临床表现及影像学特征。结果儿童气管支气管异物好发于男童(男∶女为2.23∶1),主要发病年龄为6个月至3岁(89.29%),患儿居住地农村多于城市(城市30.95%,农村69.05%),尤以农村男童为高发人群(P0.05)。能够准确提供异物吸入病史有助于早期确诊及治疗(P0.05)。吸入异物种类以可食性异物为主,以坚果类多见。气管支气管异物滞留于左、右主支气管的比例差别不大,但滞留于右侧叶支气管病例数多于左侧。不同的气道滞留部位所引起的临床症状有区别。最常见症状为咳嗽(98.81%)和喘息(58.33%),影像学有肺气肿(55.95%)表现。结论气管支气管异物重点防控对象为农村3岁以下的男童,应加强监护人对于气管支气管异物的重视,减少幼儿对坚果类食物的接触。对于反复咳嗽、喘息、查体单侧呼吸音减弱,影像学伴有肺气肿、肺不张的患儿,应重视异物吸入史或呛咳史,积极行支气管镜检查以明确诊断及治疗。
[Abstract]:Objective to investigate the clinical features of tracheobronchial foreign bodies in children.Methods 84 cases of tracheobronchial foreign bodies diagnosed and treated by bronchoscopy from June 2011 to June 2016 in Tianjin Children's Hospital were retrospectively analyzed.Clinical manifestations and imaging features.Results Foreign bodies in tracheobronchial tracheobronchial were more common in boys (male: female: 2.23: 1), the main onset age was from 6 months to 3 years old (89.29%). The children lived in rural areas more than in cities (30.95% in urban areas, 69.05% in rural areas, especially in rural boys).Accurate history of foreign body inhalation is helpful for early diagnosis and treatment of P0.05.The main types of inhaled foreign bodies were edible foreign bodies, while nuts were more common.The proportion of foreign bodies in the tracheobronchial remains in the left and the right main bronchus is not different, but the number of cases in the right lobe bronchus is more than that in the left.The clinical symptoms caused by different airway retention sites are different.The most common symptoms were cough (98.81%) and wheezing (58.33%).Conclusion the key prevention and control object of tracheobronchial foreign body is the boy under 3 years of age in rural areas. The guardian should pay more attention to the tracheobronchial foreign body and reduce the children's contact with nuts food.For the children with recurrent cough, wheezing, weak unilateral respiratory tone, emphysema and atelectasis, we should pay attention to the history of foreign body inhalation or cough, and perform bronchoscopy to make sure diagnosis and treatment.
【作者单位】：天津市儿童医院呼吸二科及感染科;
【基金】：天津市卫计委重点学科攻关项目(13KG125)
【分类号】：R768.13

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