小儿气管支气管异物诊治体会.docVIP

小儿气管支气管异物诊治体会[摘要]目的 总结小儿支气管异物的诊治与治疗体会,提高临床儿童气管异物治愈率,减少误诊率。方法 对76例儿童气管支气管异物患者的临床资料进行回顾性分析。结果76例患者中,有明确异物误吸史64例,其余12例均误诊,最终经追问病史及相关检查确定为异物。所有经支气管镜检查明确为支气管异物患儿,异物经气管镜成功取出。结论 对儿童误吸异物史不明确者,在胸透、X线胸片和胸部CT等检查均阴性时,如果高度怀疑异物,进行螺旋CT三维重建对儿童支气管异物的诊断有重要意义。 [关键词] 儿童;支气管异物;三维重建;诊治 [中图分类号] R725.6[文章标识码]A[文章编号] The Experience of Diagnosis and Treatment on Children Tracheobronchial foreign body CHEN cui-fang,LIAO tian-yi,GUO li-fang,ZHANG fa-qi Department of Otorhinolaryngology,Qing Yuan People,s Hospital , FifthAffiliated Hospital of Jinan University,Qingyuan 511500 [Abstract]Objective To investigate the practice of diagnosis and treament on children tracheobronchial foreign bodies,to improving the cure rate and reducing the rate of misdiagnosis.Methods The clinical cases of 76 patients treaed in our hospital nearly 10 years were reviewed retrospectively.Results For the 76 patients,64 cases had clear missing inhalation, 12 patients were misdiangnosed,but after asking disease history and related examination,they were sure had foreign bodiesthrough examine by the bronchuscope and diagnosing definitely. Conclusion The children who were not clear for the missing inhalation,and the examination as Xiongtou, X-ray and chest CT were negtive,Spiral CT three-dimensional reconstruction was the important value check-up for the diagnoses on foreign body in children bronchus. [Key word] Children; Bronchial foreign body; Three- dimensional reconstruction; Diagnosis and Treatment 小儿气管、支气管异物是临床常见的耳鼻咽喉科、儿科急症之一,可导致急性呼吸困难、肺不张、慢性肺部感染甚至死亡[1]。由于幼儿咽喉反射不全,咀嚼功能不完善,且有进食喜嬉笑及衔物游戏等不良习惯,所以儿童支气管异物发生率仍较高。1998年1月～2008年1月,我院共收治小儿气管支气管异物患者76例,本研究通过对其临床特征分析,以期提高临床对儿童气管异物治愈率,减少误诊率,并探讨有效的预防措施,减少小儿气管支气管异物的发生率。现将诊治情况报告如下: 1 资料与方法 1.1 临床资料 1.1.1一般资料 回顾性分析本院1998年1月～2008年1月76例支气管异物患儿,76例均为住院患儿,其中男55例、女21例,年龄11个月～12岁、平均2.5岁,2岁以内38例、3～5岁32例,6岁以上6例。异物吸入史:进食时哭闹嬉笑53例,含异物玩耍7例,原因不明2例。发病至确诊2小时～6个月,一周内来诊75.0%(57/76)。城镇患儿32例,农村患儿44例。 1.1.2临床表现 不同程度的呼吸困难39例;阵发性呛咳、喉鸣49例,声嘶27例,发热11例。其中有12例误诊,误诊为气管炎、支气管炎5例