儿童气管支气管异物的临床特征分析

Clinical features of tracheobronchial foreign bodies in children

摘要:

目的 了解儿童气管支气管异物的临床特征，为实施切实可行的预防措施提供依据。方法 回顾性分析2012年2月至2013年2月114例经纤维支气管镜确诊的气管支气管异物患儿的临床资料。结果 儿童气管支气管异物主要发生在1~3岁（71.9%），男童多于女童，性别比为2：1。冬季发生比例高于夏季。农村儿童气管支气管异物的发生比例较城市高。不同部位气管、支气管异物的CT阳性率存在明显差异，气管异物病例的胸部CT阳性率明显低于左、右主支气管异物（P<0.01）。有异物吸入史患儿的首诊误诊率明显低于无异物吸入史患儿（P<0.01）。结论 儿童气管支气管异物的预防相关健康教育应以农村地区为重点；气管支气管异物多发于1~3岁幼儿；对于气管支气管异物疑诊病例，需尽早行支气管镜检查确诊。

Abstract:

Objective To investigate the clinical features of tracheobronchial foreign bodies in children and to provide a basis for feasible preventive measures. Methods A retrospective analysis was performed on the clinical data of 114 children with tracheobronchial foreign bodies confirmed by fiberoptic bronchoscopy between February 2012 and February 2013. Results The majority (71.9%) of children with tracheobronchial foreign bodies were younger than three years old, and the male-to-female ratio was 2:l. The proportion of cases in winter was higher than that in summer. The incidence of tracheobronchial foreign bodies was significantly higher among rural children than among urban children. The positive rate of CT varied significantly for tracheobronchial foreign bodies at different sites, and the patients with tracheal foreign bodies had a significantly lower positive rate of chest CT than patients with foreign bodies in the left and right main bronchi (P<0.01). The misdiagnosis rate in children with a history of aspiration of foreign bodies was significantly lower than in children without one (P<0.01). Conclusions Health education related to the prevention of tracheobronchial foreign bodies in children should be conducted primarily in rural areas. Tracheobronchial foreign bodies are common in children younger than three years old. Bronchoscopy should be performed early for suspected cases of tracheobronchial foreign bodies.