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[儿童喉气管支气管异物:呼吸后遗症的预测因素]

[Laryngotracheobronchial foreign body in children: predictive factors of respiratory sequelae].

作者信息

Tinsa F, Yahyaoui S, Jallouli M, Bousnina D, Slim I, Zouari B, Boussetta K, Bousnina S

机构信息

Service de médecine infantile B, hôpital d'Enfants de Tunis, Place Bab Saadoun, Jabbari, Tunis, Tunisie.

出版信息

Tunis Med. 2010 May;88(5):330-4.

Abstract

BACKGROUND

Inhalation of laryngotracheobronchial foreign body in children is a serious accident that may compromise the prognosis of the child and the respiratory function in the long term.

AIM

identify the predictive factors of respiratory sequelae of laryngotracheobronchial foreign body inhalation.

METHODS

This retrospective study was conducted in the children hospital of Tunis during a period of nine years (2000 - 2008). In all statistical tests, the significance level was set at 0.05.

RESULTS

60 children were included in the study. The average age was 24.9 +/- 3.4 months. 2 / 3 of the children were boys. The foreign body was plant in 80% of cases. The penetration syndrome was reported in 83.7% of cases. The average time of stay of foreign body was 14 days. The chest radiograph was abnormal in 77.4% of cases. Endoscopic extraction was performed in 59 cases and a pneumectomy was conducted in one child. 30 children were followed for an average of 23 months. 18 children had not respiratory sequelae (clinical, radiological and scintigraphic). 10 children had respiratory sequelae (clinical and radiological and/or scintigraphic) at the last follow-up and four patients developed bronchial dilatation. Respiratory sequelae were correlated with the stay period of the foreign body exceeding 84H. Neither age, nor sex, nor the nature of foreign body or its location, nor the presence of radiological opacity at the initial radiograph, were predictive factors of respiratory sequelae.

CONCLUSION

The inhalation of foreign body is a serious accident affecting essentially male infants. Clinical, radiological and scintigraphic follow up is mandatory.

摘要

背景

儿童喉气管支气管异物吸入是一种严重事故,可能长期影响儿童预后及呼吸功能。

目的

确定喉气管支气管异物吸入后呼吸后遗症的预测因素。

方法

本回顾性研究在突尼斯儿童医院进行,为期九年(2000 - 2008年)。所有统计检验的显著性水平设定为0.05。

结果

60名儿童纳入研究。平均年龄为24.9±3.4个月。三分之二的儿童为男孩。80%的病例异物为植物性。83.7%的病例出现穿透综合征。异物停留的平均时间为14天。77.4%的病例胸部X线片异常。59例进行了内镜下取出术,1名儿童进行了肺切除术。30名儿童平均随访23个月。18名儿童无呼吸后遗症(临床、放射学和闪烁扫描学方面)。10名儿童在最后一次随访时有呼吸后遗症(临床、放射学和/或闪烁扫描学方面),4名患者出现支气管扩张。呼吸后遗症与异物停留时间超过84小时相关。年龄、性别、异物性质或位置、初始X线片是否存在放射学不透明影均不是呼吸后遗症的预测因素。

结论

异物吸入是一种主要影响男婴的严重事故。必须进行临床、放射学和闪烁扫描学随访。

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