Chung Man Ki, Jeong Han-Sin, Ahn Kang Mo, Park Shin-Hong, Cho Jae Keun, Son Young-Ik, Baek Chung-Hwan
Department of Otorhinolaryngology - Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
Laryngoscope. 2007 Feb;117(2):303-7. doi: 10.1097/01.mlg.0000250788.93900.ef.
The aim of this study was to determine how long postoperative pulmonary care is needed in patients after rigid bronchoscopic retrieval of foreign body from the airway and to identify the factors affecting pulmonary recovery.
A retrospective review of 98 pediatric patients who had foreign body removed from the airway by rigid bronchoscopic procedure was conducted. After the removal of the foreign body, the time required for complete clinical and radiologic pulmonary recovery was reviewed for each subject. Factors examined included age, sex, preoperative symptoms, preoperative radiologic findings, duration between the aspiration event and treatment, the type of foreign body, the location of foreign body impaction, operation time, immediate postoperative radiologic changes, and treatment outcome.
More than 1 week for the complete pulmonary recovery was required in 25 (25.5%) cases, whereas 74.5% of subjects fully recovered within 1 week after the removal of foreign body. In the univariate analysis, preoperative inflammatory symptoms, and radiologic findings, an operation time of over 50 minutes and the aggravation of immediate postoperative radiologic findings predicted a delayed pulmonary recovery (more than 1 week). In the multivariate analysis, three of four variables previously noted, except preoperative inflammatory symptoms, showed significant predictability for a delayed pulmonary recovery.
The recovery time of more than 1 week after rigid bronchoscopic retrieval of airway foreign body was associated with preoperative inflammatory findings by radiologic study, a prolonged procedure over 50 minutes, and aggravation of the immediate postoperative radiologic findings. Therefore, long-term pulmonary care is required for this group of patients.
本研究旨在确定气道异物经硬质支气管镜取出术后患者所需的术后肺部护理时长,并识别影响肺部恢复的因素。
对98例经硬质支气管镜手术从气道取出异物的儿科患者进行回顾性研究。异物取出后,对每名患者临床和影像学上肺部完全恢复所需的时间进行评估。所考察的因素包括年龄、性别、术前症状、术前影像学表现、误吸事件与治疗之间的时长、异物类型、异物嵌顿位置、手术时间、术后即刻影像学变化以及治疗结果。
25例(25.5%)患者肺部完全恢复需要超过1周时间,而74.5%的患者在异物取出后1周内完全恢复。单因素分析显示,术前炎症症状、影像学表现、手术时间超过50分钟以及术后即刻影像学表现加重预示着肺部恢复延迟(超过1周)。多因素分析显示,除术前炎症症状外,之前提到的四个变量中有三个对肺部恢复延迟具有显著的预测性。
气道异物经硬质支气管镜取出术后恢复时间超过1周与术前影像学检查发现的炎症表现、手术时间延长超过50分钟以及术后即刻影像学表现加重有关。因此,这组患者需要长期的肺部护理。