Soysal Omer, Kuzucu Akin, Ulutas Hakki
Inonu University Faculty of Medicine, Turgut Ozal Medical Center, Department of Thoracic Surgery, 44315 Malatya, Turkey.
Otolaryngol Head Neck Surg. 2006 Aug;135(2):223-6. doi: 10.1016/j.otohns.2005.09.035.
The aim was to present the features and outcomes for 140 cases of foreign body aspiration and to discuss specific problems and new management recommendations.
Records were retrospectively reviewed and the following data were recorded for each patient: age, sex, symptoms, duration of symptoms, findings on physical examination and chest radiography, location and type of foreign body, complications related to aspiration itself or to extraction, and outcome.
Seventy-eight (55.7%) patients presented within 24 hours of aspiration. The most common symptoms and findings were cough, dyspnea-stridor, decreased breath sounds, radiopaque foreign body, air trapping, and atelectasis. All 140 patients underwent rigid bronchoscopy, and 110 had the foreign material extracted via the scope. No foreign body was detected bronchoscopically in 25 cases. In the other 5 cases, the material was visualized but could not be removed via the scope, and 3 of these patients required thoracotomy for removal. Eleven patients developed morbidity after bronchoscopy.
History suggestive of foreign body aspiration is a definite indication for bronchoscopy, and bronchoscopic extraction should only be performed by experts. Each case tends to present different challenges, and endotracheal intubation and tracheotomy may be required.
呈现140例异物吸入病例的特征及结果，并讨论具体问题和新的管理建议。
对病例记录进行回顾性分析，记录每位患者的以下数据：年龄、性别、症状、症状持续时间、体格检查及胸部X线检查结果、异物位置及类型、与吸入本身或取出相关的并发症以及结局。
78例（55.7%）患者在吸入后24小时内就诊。最常见的症状和表现为咳嗽、呼吸急促-喘鸣、呼吸音减弱、不透射线异物、气体潴留和肺不张。所有140例患者均接受了硬质支气管镜检查，其中110例通过该镜取出异物。25例经支气管镜未发现异物。另外5例中，异物可见但无法通过支气管镜取出，其中3例患者需开胸取出。11例患者在支气管镜检查后出现并发症。
提示异物吸入的病史是支气管镜检查的明确指征，且支气管镜取出术应由专家进行。每个病例往往会带来不同的挑战，可能需要气管插管和气管切开术。
