Ludemann J P, Riding K H
Division of Otolaryngology, BC Children's Hospital, Vancouver, BC, Canada.
Int J Pediatr Otorhinolaryngol. 2007 Feb;71(2):307-10. doi: 10.1016/j.ijporl.2006.10.017. Epub 2006 Nov 29.
To review the demographics, pathophysiology and management of aspiration of sharp, metallic foreign bodies; to review prevention strategies.
Case series and review of the related literature (1932-2006).
Tertiary care pediatric hospital.
All patients presenting to BC Children's Hospital with aspiration of sharp, metallic foreign bodies since 1998.
The seven patients ranged in age from 11 to 15 years (mean 13 years). The two boys had been playing with other boys at the time of aspiration. One aspirated a thumbtack and one aspirated a homemade blowdart (which traveled from his carina to his subglottis with coughing). Three of the five girls had been holding thumbtacks or a darting pin between their lips while putting up posters or sewing. The other two girls, who aspirated thumbtacks, refused to provide a history. One was treated successfully 6 days after the aspiration. The other girl withheld the history for over a year, presented with hemoptysis and eventually required thoractomy and right main bronchotomy to remove the tack. All of the other patients were diagnosed and successfully treated by rigid bronchoscopy within 24h. (Two patients initially had a failed attempt at foreign body removal by flexible bronchoscopy at another hospital.) This is the second largest series of aspiration of sharp, metallic foreign bodies since at least 1966. Adolescents are still aspirating sharp, metallic foreign bodies because of the same behaviors described by Jackson and Jackson in 1932. Education about choking hazards is needed for this age group.
Aspiration of a sharp, metallic foreign body is a serious injury which is best treated by rigid bronchoscopy. These injuries potentially could be prevented through education.
回顾尖锐金属异物误吸的人口统计学特征、病理生理学及处理方法；回顾预防策略。
病例系列研究及相关文献（1932 - 2006年）回顾。
三级护理儿童医院。
1998年以来所有因尖锐金属异物误吸而就诊于卑诗省儿童医院的患者。
7例患者年龄在11至15岁之间（平均13岁）。2名男孩在误吸时正与其他男孩玩耍。1名误吸了一枚图钉，1名误吸了一个自制吹箭（咳嗽时从隆突移至声门下）。5名女孩中有3名在张贴海报或缝纫时将图钉或大头针含在嘴唇间。另外2名误吸图钉的女孩拒绝提供病史。其中1名在误吸6天后成功治愈。另一名女孩隐瞒病史一年多，出现咯血，最终需要开胸手术及右主支气管切开术取出图钉。所有其他患者均在24小时内通过硬支气管镜检查确诊并成功治疗。（2例患者最初在另一家医院尝试通过软支气管镜取出异物失败。）这是自1966年以来第二大例尖锐金属异物误吸系列病例。青少年仍因杰克逊和杰克逊在1932年所描述的相同行为而误吸尖锐金属异物。该年龄组需要进行窒息风险教育。
尖锐金属异物误吸是一种严重损伤，最好通过硬支气管镜检查进行治疗。通过教育有可能预防这些损伤。
