气管异物的学习材料.pptxVIP

气管异物的学习材料第1页/共31页 Foreign body aspiration can result a spectrum of changes, from minimal symptoms, to respiratory compromise, failure, and even death. 第2页/共31页 EtiologyForeign body aspiration is most common in children aged 6 months to 4 years. They lack molars for proper grinding of food. They tend to be running or playing at the time of aspiration. They tend to put objects in their mouth more frequently. They lack coordination of swallowing and glottic closure.第3页/共31页 EtiologyAdults who are unable to protect the airway, are also at risk of aspiration due to decreased airway protective mechanisms. Mental retardationAlcoholismPsychosesNeurologic disorders第4页/共31页 A drawing pin in the left main bronchusA peanut in the right main bronchus第5页/共31页 AnatomyMost foreign bodies lodged distal to the larynx and trachea in the right mainstem bronchus. The diameter of the right main bronchus is larger than the left.The angle of divergence from the tracheal axis is smaller on the right.Airflow through the right lung is greater than through the left. The carina is more likely to be located to the left of midline rather than to the right. 第6页/共31页 PathophysiologyAspirated foreign bodies most commonly are lodged in the right main stem and lower lobe. Peanuts are by far the most commonly aspirated material in children, followed by organic material such as sunflower seeds, pieces of vegetables, and hazelnuts.In adults, vegetable matter, meat, and bones rank highest, followed by dental and medical appliances. Aspiration of teeth after trauma is observed occasionally. 第7页/共31页 Clinical FeaturesTracheal foreign bodiesAn audible slap heard at the open mouth during cough.Palpable slap with respirations.Asthmatoid wheeze heard with the ear at the patients mouth.第8页/共31页 Clinical FeaturesBronchial foreign bodiesThree distinct stages of a foreign body accident: Initial phase - Choking and gasping, coughing, or airway obstruction at the time of aspiration Asymptomatic phase - Subsequent lod