儿童气管支气管异物的临床研究-儿科学专业论文.docxVIP

儿童气管支气管异物的临床研究 中文摘要 儿童气管支气管异物的临床研究 中文摘要 目的：对儿童气管、支气管异物（TBF）的临床特点分析，探讨TBF临床特征， 为提高TBF的诊断和治疗水平提供一定帮助。 方法：系统回顾了苏州大学附属儿童医院于2007年05月～2013年08月经耳鼻喉科 和呼吸科收治确诊的TBF患儿，对其发病年龄、性别、诱发因素、病程、临床特点、 影像学表现、异物性质、异物位置、误诊、治疗及转归等进行分析。 结果：入选759例病例中，男505例，女254例，男女比例约为2:1。年龄最小4月， 年龄最大11岁，平均年龄（21±12.4）月。3岁以下儿童占94.07%。主要的诱发因素 为不慎（54.63%）。异物种类繁多，其中植物性异物最多，共705例，占总例数的93.38% （705/755）。植物性异物中以花生(350例)、瓜子（194例）为主。左侧支气管（383 例）略多于右侧支气管（328例）。主要临床表现为咳嗽（723例）、呛咳（687例） 和气喘（661例）。除4例自行咳出外，其余755例均在全身麻醉下行硬支气管镜异物 取出术安全取出。 结论：1.儿童气管、支气管异物好发于3岁以内的婴幼儿，且男孩比女孩多发。2. 明确的异物吸入史对支气管异物的诊断非常重要。3.支气管异物以植物性异物为主， 其中又以花生、瓜子最为常见。4.左侧支气管异物并不比右侧少。5.主要临床表现为 咳嗽和喘息，容易误诊为呼吸道感染。6.全身麻醉下行硬支气管镜检查和异物取出术 是诊断和治疗儿童TBF安全有效的方法。 关键词：儿童；气管支气管异物；临床研究 作 者：李 胜 指导老师：郝创利 窦训武 Abstract Clinical Research of Childrens tracheobronchial foreign body Clinical Research of Childrens tracheobronchial foreign body Abstract Objective To analyze the clinical features, diagnosis, and treatment of tracheobronchial foreign body (TBF) in children. There is a certain help to improve the level of diagnosis and treatment in children with TBF. Methods A retrospective study with TBF in ENT and Respiratory departments from May 2007 to August 2013 in Soochow University Affiliated Childrens Hospital. Their age, gender, predisposing factors, duration and misdiagnosis, clinical features, imaging findings, the nature of foreign body, foreign body position, treatment and outcome were analyzed. Results 759 cases were enrolled in this study, including 505 male and 254 female. The ratio of male to female was about 2:1. The youngest was 4 months old, while the oldest was 11 years old and the average age was (21±12.4) months. The percentage of Children under 3 years old was 94.07%. The major predisposing factor was careless (54.63%). The foreign bodies were various, of which the vegetable foreign body was most common, accounting for 93.38% of all the cases(705/755). The peanuts and melon seeds were the main vegetable