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[儿童不规则形状气道异物的处理]

[Management of irregular shaped airway foreign body in children].

作者信息

Zhang Y, Zhang Z

机构信息

Department of Otorhinolaryngology, Affiliated Beijing Children's Hospital, Capital University of Medical Sciences, Beijing 100045, China.

出版信息

Zhonghua Er Bi Yan Hou Ke Za Zhi. 2001 Jun;36(3):231-4.

Abstract

OBJECTIVE

To explore proper operative methods for removal of irregular shaped foreign bodies in children.

METHODS

Forty-eight emergency cases of irregular shaped airway foreign bodies (plastic ball-pen cap, mini-toys, whistle, pin, thumbtack, milk tooth, pen, steel ball, stone of apricot, chicken bone and screw nail) from Jan. 1998 to Nov. 2000 have been reviewed, especially the operative procedure for removing foreign bodies. The youngest patient was 9-month old and eldest 14 year-old. The average age was 8.3 year-old. The male female ratio was 2.4 storz tracheoscope (Made in German) was applied.

RESULTS

Forty-six of the 48 foreign bodies were removed through tracheoscope. The foreign bodies slipped off at the level of the glottis in 3 cases, they were then removed from the opposite bronchus (respiratory difficult syndrome developed in these cases); a thumbtack was removed by tracheotomy; one stone of apricot was removed through.

CONCLUSIONS

An accurate pre-operative diagnosis is most important in operative management of cases of irregular shaped foreign bodies. General anesthesia, is usually. If the foreign body is too big to pass through the glottis, removing by tracheotomy should be considered.

摘要

目的

探讨儿童不规则形状异物取出的合适手术方法。

方法

回顾了1998年1月至2000年11月期间48例不规则形状气道异物(塑料圆珠笔帽、小玩具、口哨、大头针、图钉、乳牙、笔、钢珠、杏核、鸡骨和螺丝钉)的急诊病例,尤其关注异物取出的手术过程。最年幼的患者9个月大,最年长的14岁。平均年龄8.3岁。男女比例为2.4∶1。应用德国产的STORZ气管镜。

结果

48例异物中有46例通过气管镜取出。3例异物在声门水平滑落,随后从对侧支气管取出(这些病例出现了呼吸窘迫综合征);1枚图钉通过气管切开取出;1枚杏核通过……取出。

结论

在不规则形状异物病例的手术治疗中,准确的术前诊断最为重要。通常采用全身麻醉。如果异物太大无法通过声门,应考虑通过气管切开取出。

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