Díaz G A, Valledor L, Seda F
Bol Asoc Med P R. 2000 Sep-Dec;92(9-12):124-9.
The objective of this study was to investigate the incidence management, and complications of foreign bodies in the upper aerodigestive tract of children in Puerto Rico. The records of children admitted to the University Pediatric Hospital of Puerto Rico were revised from January 1, 1989 to December 31, 1994. 51 children had foreign body in their airway and 107 children had foreign body in their digestive trac (a total of 158 patients) These records were examined for age, gender, previous medical illness, clinical presentation, radiographic studies, removal technique, complications, and hospital stay. The most common age in both groups was 1 year old children. Of the 51 foreign bodies aspirations, 25 were boys and 26 were girls; and of the 107 ingestion, 67 were boys and 40 were girls. The most common times of the year were during the summer and winter months. The diagnosis of foreign body aspiration or ingestion was made in 6 hours or less in only 68 of the 158 cases. The most common signs were vomiting, coughing, and choking episode (44 cases). X-rays were positive in 146 cases (92.4%). The most common foreign body ingestion was coins and aspiration was peanuts. There were no complications on 129 cases (81.6%). The most common complication was pneumonia with 19 cases. The mean hospital stay was 3 days. In general, foreign body aspiration or ingestion are common events that can be prevented in the pediatric age. Parental education is important at this stage. If the event can't be prevented then a rapid management must be given to those patients with positive history of an adult witness of the event and a high level of suspicion for those patients with no reported event of choking or witness present.
本研究的目的是调查波多黎各儿童上呼吸道消化道异物的发生率、处理及并发症情况。对1989年1月1日至1994年12月31日期间入住波多黎各大学儿童医院的儿童病历进行了回顾。51名儿童气道中有异物,107名儿童消化道中有异物(共158例患者)。对这些病历进行了年龄、性别、既往病史、临床表现、影像学检查、取出技术、并发症及住院时间等方面的检查。两组中最常见的年龄均为1岁儿童。在51例异物吸入病例中,25例为男孩,26例为女孩;在107例异物吞食病例中,67例为男孩,40例为女孩。一年中最常见的时间是夏季和冬季。158例病例中只有68例在6小时或更短时间内诊断出异物吸入或吞食。最常见的症状是呕吐、咳嗽和窒息发作(44例)。146例(92.4%)X线检查呈阳性。最常见的吞食异物是硬币,吸入异物是花生。129例(81.6%)无并发症。最常见的并发症是肺炎,共19例。平均住院时间为3天。总体而言,异物吸入或吞食在儿童期是常见事件,是可以预防的。在此阶段,家长教育很重要。如果事件无法预防,那么对于有成人目睹事件且病史明确的患者应迅速进行处理,对于无窒息或目睹事件报告但高度怀疑的患者也应如此。