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[246例儿童支气管异物的临床分析]

[Clinical analysis of bronchial foreign bodies in 246 children].

作者信息

Ma Yu-yan, Jiao An-xia, Jiang Qin-bo, Rao Xiao-chun, Pan Yue-na, Liu Xi-cheng

机构信息

Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2010 May 11;90(18):1272-4.

Abstract

OBJECTIVE

To analyze the characters of bronchial foreign bodies in children and the utilization of bronchoscope in the treatment of bronchial foreign bodies.

METHODS

A total of 246 children were diagnosed with bronchial foreign bodies at our hospital during January 2000 until August 2009. Under local mucosal anesthesia, a bronchoscope was inserted through nasal cavity into bronchi. After identifying the site of foreign body, grasping forceps was guided through bronchoscope to remove the foreign body from airway.

RESULTS

Among 246 cases, hard nut and skin of melon seed were found (n = 230, 93.5%). The most common site of foreign body was in right lower lobe bronchi (n = 98, 38.9%). The average operative frequency was 1.9 +/- 1.3 and one-time extraction ratio 58.5% (n = 144). The one-time extraction ratio of patients with foreign body obstructed in main bronchi (91.1%), right middle lobe (60.0%) and right lower lobe (55.1%) was higher than others. The operation frequency of using basket grasping forceps (1.4 +/- 0.9) was lower than those using tooth type forceps (2.1 +/- 1.4). And the difference was significant (P = 0.000).

CONCLUSION

For bronchial foreign body in pediatric patients, hard nut and skin of melon seed are the most common foreign bodies. The right and left lower lobe bronchi are the predilection site. Foreign body in main bronchus is the easiest to be removed by grasping forceps. For massive foreign bodies, basket grasping forceps fares better than tooth grasping forceps.

摘要

目的

分析儿童支气管异物的特点及支气管镜在支气管异物治疗中的应用。

方法

2000年1月至2009年8月我院共诊断246例儿童支气管异物。在局部黏膜麻醉下,经鼻腔插入支气管镜至支气管。确定异物部位后,通过支气管镜引导抓取钳从气道取出异物。

结果

246例中,发现硬果壳及瓜子皮230例(93.5%)。异物最常见部位为右下叶支气管(98例,38.9%)。平均手术次数为1.9±1.3次,一次取出率为58.5%(144例)。异物阻塞于主支气管(91.1%)、右中叶(60.0%)及右下叶(55.1%)的患者一次取出率高于其他部位。使用网篮抓取钳的手术次数(1.4±0.9次)低于齿形钳(2.1±1.4次),差异有统计学意义(P = 0.000)。

结论

小儿支气管异物中,硬果壳及瓜子皮最为常见。左右下叶支气管为好发部位。主支气管异物最易通过抓取钳取出。对于大量异物,网篮抓取钳优于齿形抓取钳。

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