CAJ | 학술논문

目的回顾性研究儿童支气管异物的临床特点以及电子支气管镜在诊断治疗儿童支气管异物中的作用.方法 2000年1月至2009年8月北京儿童医院经支气管镜诊断治疗的支气管异物患儿246例,应用Olympus电子支气管镜,在局部黏膜麻醉下经鼻插入支气管镜逐级观察支气管结构,使用篮状异物钳或齿状异物钳钳取异物.结果 246例患儿中,支气管异物以果仁或果壳类(230例,占93.5%)最为常见,异物嵌顿位置以右下叶支气管开口(98例,占39.8%)为最多.钳取异物手术次数平均为(1.9±1.3)次,一次取出率为58.5%(144例).阻塞于左右主支气管、右中叶和右下叶支气管的异物一次取出率较高,分别为91.1%、60.0%和55.1%.篮状异物钳钳取所需次数(1.4±0.9)明显低于齿状异物钳所需次数(2.1±1.4),差异有统计学意义(P=0.000).结论儿童支气管异物种类以果仁或果壳类植物性异物为主,阻塞部位以右下支气管为多见.位于左右主支气管异物一次取出率明显高于其他部位.用篮状异物钳钳取异物所需手术次数明显少于使用齿状异物钳.
목적 회고성연구인동지기관이물적림상특점이급전자지기관경재진단치료인동지기관이물중적작용.방법 2000년1월지2009년8월북경인동의원경지기관경진단치료적지기관이물환인246례,응용Olympus전자지기관경,재국부점막마취하경비삽입지기관경축급관찰지기관결구,사용람상이물겸혹치상이물겸겸취이물.결과 246례환인중,지기관이물이과인혹과각류(230례,점93.5%)최위상견,이물감돈위치이우하협지기관개구(98례,점39.8%)위최다.겸취이물수술차수평균위(1.9±1.3)차,일차취출솔위58.5%(144례).조새우좌우주지기관、우중협화우하협지기관적이물일차취출솔교고,분별위91.1%、60.0%화55.1%.람상이물겸겸취소수차수(1.4±0.9)명현저우치상이물겸소수차수(2.1±1.4),차이유통계학의의(P=0.000).결론 인동지기관이물충류이과인혹과각류식물성이물위주,조새부위이우하지기관위다견.위우좌우주지기관이물일차취출솔명현고우기타부위.용람상이물겸겸취이물소수수술차수명현소우사용치상이물겸.
Objective To analyze the characters of bronchial foreign bodies in children and the utilization of bronchoscope in the treatment of bronchial foreign bodies. Methods A total of 246 children were diagnosed with bronchial foreign bodies at our hospital during January 2000 until August 2009. Under local mucosal anesthesia, a bronchoscope was inserted through nasal cavity into bronchi. After identifying the site of foreign body, grasping forceps was guided through bronchoscope to remove the foreign body from airway. Results Among 246 cases, hard nut and skin of melon seed were found ( n = 230, 93.5% ). The most common site of foreign body was in right lower lobe bronchi ( n =98, 38.9% ). The average operative frequency was 1.9 ± 1.3 and one-time extraction ratio 58.5% ( n = 144). The one-time extraction ratio of patients with foreign body obstructed in main bronchi (91. 1% ), right middle lobe (60.0%) and right lower lobe (55. 1% ) was higher than others. The operation frequency of using basket grasping forceps ( 1.4 ±0.9) was lower than those using tooth type forceps (2.1 ± 1.4). And the difference was significant (P = 0. 000). Conclusion For bronchial foreign body in pediatric patients, hard nut and skin of melon seed are the most common foreign bodies. The right and left lower lobe bronchi are the predilection site.Foreign body in main bronchus is the easiest to be removed by grasping forceps. For massive foreign bodies,basket grasping forceps fares better than tooth grasping forceps.