Takenaka Masaru, Hanagiri Takeshi, Ono Kenji, Oka Soichi, Kuwata Taiji, Baba Tetsuro, Shigematsu Yoshiki, Shimokawa Hidehiko, Nagata Yoshika, Uramoto Hidetaka, Tanaka Fumihiro
Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Japan, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
J UOEH. 2011 Jun 1;33(2):157-61. doi: 10.7888/juoeh.33.157.
The aspiration of foreign bodies into the bronchus frequently occurs in children as well as in elderly people. Foreign bodies in the airway not only cause chronic cough and pneumonia, but also result in life-threatening conditions, such as dyspnea and cyanosis. This report presents the clinical characteristics of 6 patients with bronchial foreign bodies who were treated between 2006 and 2010, including 4 male and 2 female patients. The age of the patients ranged from 8 to 83 years old. Foreign bodies were located in the right bronchial tree in all the patients. Chest X-rays showed pneumonia or atelectasis in 5 out of 6 patients. The foreign bodies were an artificial teeth or a tooth in 5 patients, and a fish bone in 1 patient. Five patients had fiberoptic bronchoscopy under local anesthesia, although an 8-year-old girl required general anesthesia with a laryngeal mask. Surgery was needed in only one case. Bronchial foreign bodies present a large range of symptoms, from trivial symptoms to irreversible damage to the bronchus and the lung, which can be life threatening. Nonspecific respiratory symptoms may be mistakenly attributed to other medical diagnoses unless there is a clear history of aspiration. However, an early diagnosis is very important, because inflammatory granulation due to long-term impaction of foreign bodies makes its removal difficult.
异物吸入支气管在儿童和老年人中都很常见。气道中的异物不仅会导致慢性咳嗽和肺炎,还会引发危及生命的状况,如呼吸困难和发绀。本报告介绍了2006年至2010年间接受治疗的6例支气管异物患者的临床特征,其中男性4例,女性2例。患者年龄在8岁至83岁之间。所有患者的异物均位于右支气管树。6例患者中有5例胸部X线显示肺炎或肺不张。5例患者的异物为假牙或牙齿,1例患者的异物为鱼骨。5例患者在局部麻醉下接受了纤维支气管镜检查,不过一名8岁女孩需要使用喉罩进行全身麻醉。仅1例需要手术。支气管异物会出现从轻微症状到支气管和肺部不可逆转损伤等一系列症状,这些损伤可能危及生命。除非有明确的误吸史,否则非特异性呼吸道症状可能会被误诊为其他疾病。然而,早期诊断非常重要,因为异物长期嵌顿导致的炎性肉芽会使其难以清除。