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异物吸入:临床、影像学表现及其延迟取出的相关因素

Foreign body aspiration: clinical, radiological findings and factors associated with its late removal.

作者信息

Bittencourt Paulo Fernando Souto, Camargos Paulo Augusto Moreira, Scheinmann Pierre, de Blic Jacques

机构信息

Department of Pediatrics, School of Medicine, Federal University of Minas Gerais, Avenida Alfredo Balena 190, Room 4061, 30130-100 Belo Horizonte, Brazil.

出版信息

Int J Pediatr Otorhinolaryngol. 2006 May;70(5):879-84. doi: 10.1016/j.ijporl.2005.09.024. Epub 2005 Nov 8.

DOI:10.1016/j.ijporl.2005.09.024
PMID:16280171
Abstract

OBJECTIVE

The study was carried out to assess the clinical and radiological findings and factors related to delay in definite diagnosis of foreign body aspiration and its removal.

METHODS

Medical charts of 280 bronchoscopic-proven foreign body (FB) inhalators were reviewed. To analyze factors related to late removal, the population studied was divided into two groups according to time elapsed between injury and care-seeking (up to 24h and longer than 24h) followed by FB removal.

RESULTS

Most children (69.5%) were under three, most were males (63.1%) and in 47.5%, rigid bronchoscopy was performed 24h after the accident. Organic foreign bodies were found in 63.4% of cases, most frequently peanuts (20.5%). Mortality related to FB aspiration reached 0.7%. In comparison with endoscopic diagnosis, clinical and radiological abnormalities were found in 99.3 and 84.3% (95% CI, 79.5-88.4%) of studied patients, respectively. The number of health services sought until definite diagnosis was the only factor associated with late removal (OR=23.0, 95% CI, 10.7-49.3%, p<0.001).

CONCLUSION

The population studied presented a long delay in FB removal, thus demanding actions enhancing parent, physician and health services awareness, aiming at an earlier referral for diagnostic and therapeutic bronchoscopy.

摘要

目的

本研究旨在评估异物吸入明确诊断的临床和影像学表现以及与之相关的延误诊断和取出的因素。

方法

回顾了280例经支气管镜证实的异物吸入患者的病历。为分析与延迟取出相关的因素,根据受伤至就医(直至24小时和超过24小时)后取出异物的时间,将研究人群分为两组。

结果

大多数儿童(69.5%)年龄在3岁以下,大多数为男性(63.1%),47.5%的患者在事故发生24小时后进行了硬质支气管镜检查。63.4%的病例发现有机异物,最常见的是花生(20.5%)。异物吸入相关死亡率达0.7%。与内镜诊断相比,分别在99.3%和84.3%(95%CI,79.5 - 88.4%)的研究患者中发现临床和影像学异常。直至明确诊断前寻求医疗服务的次数是与延迟取出相关的唯一因素(OR = 23.0,95%CI,10.7 - 49.3%,p < 0.001)。

结论

本研究人群在异物取出方面存在长时间延迟,因此需要采取行动提高家长、医生和医疗服务机构的意识,以便更早地转诊进行诊断性和治疗性支气管镜检查。

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