CAJ | 학술논문

目的总结儿童气管、支气管异物的临床诊断与治疗方法.方法回顾性分析经直达喉镜、硬质气管镜确诊的120例儿童气管支气管异物的临床表现、影像学改变及异物取出方法.结果 120例气管支气管异物中,109例患儿有异物吸入史;120例患儿有侵入综合征;气管拍击音在气管异物中的出现率为66.7%(26/39);59例患儿X线胸部透视下呼气时可见纵隔向健侧摆动,均被气管镜确诊有异物;经CT诊断的气管支气管异物准确率为86.2%(25/29);均行喉镜、支气管镜检查加异物取出术而得以确诊和治疗,119例异物被成功取出,1例转胸外科治疗.结论异物吸入史、侵入综合征、气管拍击音和X线检查中的纵隔摆动是诊断气管支气管异物的重要证据,胸部CT诊断气管支气管异物准确率较高,直达喉镜气管镜检查是确诊气管支气管异物重要方法;直达喉镜、硬质气管镜下气管异物取出术是治疗气管支气管异物的有效方法.
목적 총결인동기관、지기관이물적림상진단여치료방법.방법 회고성분석경직체후경、경질기관경학진적120례인동기관지기관이물적림상표현、영상학개변급이물취출방법.결과 120례기관지기관이물중,109례환인유이물흡입사;120례환인유침입종합정;기관박격음재기관이물중적출현솔위66.7%(26/39);59례환인X선흉부투시하호기시가견종격향건측파동,균피기관경학진유이물;경CT진단적기관지기관이물준학솔위86.2%(25/29);균행후경、지기관경검사가이물취출술이득이학진화치료,119례이물피성공취출,1례전흉외과치료.결론 이물흡입사、침입종합정、기관박격음화X선검사중적종격파동시진단기관지기관이물적중요증거,흉부CT진단기관지기관이물준학솔교고,직체후경기관경검사시학진기관지기관이물중요방법;직체후경、경질기관경하기관이물취출술시치료기관지기관이물적유효방법.
Objective To analyze the clinical diagnosis and treatment of pediatric tracheo-bronchial foreign body cases and therapeutic effects. Methods A retrospective review of the clinical manifestations, the feature of ima- geology and the methods of removing foreign body of 120 cases of pediatric tracheobronchial foreign body, which were confirmed with tracheobronchial foreign body by direct laryngoscope or rigid bronchoscope. Results History of aspiration was present in 90.8 % (109/120) of all cases, penetration syndrome was present in 100 % (120/120) of all cases. Among 39 cases with tracheal foreign body, there were 26 cases with audible flapping sound in trachea, the fre- quency was 66.7 %. With the X-ray chest fluoroscopy showing media-stinal swaying,59 cases were confirmed to be with foreign body by bronchoscope. The accurate rate of diagnosing traeheobronehial foreign body via CT was 86.2 % (25/29). All cases were confirmed and treated by direct laryngoscope and rigid bronchoscope. The foreign bodies of 119 cases were successfully removed. 1 patient was turned into the department of chest surgery. Conclusion History of aspiration, penetration syndrome, audible flapping sound in trachea, X-ray chest fluoroscopy showing mediastinal swaying are important evidence in diagnosing tracheobronchial foreign body. The accurate rate of diag- nosing tracheobronchial foreign body via chest CT is relatively high. Direct laryngoscope and bronchoscopy are con- firming methods in diagnosing tracheobronehial foreign body; it is effective methods to remove traehco-bronchial for- eign body by direct laryngoscope and rigid bronchoscope.