Iversen Rikke Haahr, Klug Tejs Ehlers
Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, 8000 Aarhus C, Denmark.
Dan Med J. 2012 Sep;59(9):A4498.
Foreign body (FB) aspiration is a common cause of respiratory emergency in early childhood and is associated with a high rate of airway distress. FB aspiration peaks at the age of 1-2 years. Factors placing children at higher risk include incomplete dentition, immature swallowing coordination and the tendency to be easily distracted while eating. Symptoms may vary from an un-affected child to impending airway failure. Mucosal cough receptors often accommodate and the child may be asymptomatic when evaluated.
Files of children (0-15 years) admitted with suspected FB aspiration were reviewed. Patients were included if the FB was confirmed by bronchoscopy.
Among 136 children undergoing bronchoscopy, a FB was confirmed in 59 patients. The median age was one year. All children had a history of aspiration and in 48% a persistent cough was present at the initial examination. Eleven children (19%) had a normal physical examination at admission. Nuts were identified in 34% and carrots in 20%. Of the FBs removed, 86% were organic and 14% were inorganic. Organic FBs were more common in patients younger than three years (p < 0.001).
Parental suspicion of FB aspiration indicates acute bronchoscopy in children, even in case of no abnormal findings. The completion of the bronchoscopy within 24 hours facilitates the examination and reduces the risk of complications. We recommend increased awareness of the hazards associated with small crunchy organic food items, especially nuts and carrots, given to children under three years of age.
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not relevant.
异物吸入是幼儿期呼吸急症的常见原因，且与气道窘迫的高发生率相关。异物吸入在1至2岁时达到高峰。使儿童面临更高风险的因素包括牙齿未完全萌出、吞咽协调不成熟以及进食时容易分心的倾向。症状可能从无影响的儿童到即将出现气道衰竭不等。黏膜咳嗽感受器常常会适应，因此在评估时儿童可能无症状。
回顾了因疑似异物吸入而入院的儿童（0至15岁）的病历。如果通过支气管镜检查确认有异物，则纳入患者。
在136例接受支气管镜检查的儿童中，59例确认有异物。中位年龄为1岁。所有儿童都有异物吸入史，48%的儿童在初次检查时有持续性咳嗽。11名儿童（19%）入院时体格检查正常。34%的异物为坚果，20%为胡萝卜。在取出的异物中，86%为有机异物，14%为无机异物。有机异物在3岁以下患者中更为常见（p<0.001）。
即使没有异常发现，家长怀疑有异物吸入也表明儿童需要进行急性支气管镜检查。在24小时内完成支气管镜检查有助于检查并降低并发症风险。鉴于3岁以下儿童食用小而脆的有机食品（尤其是坚果和胡萝卜）存在危害，我们建议提高对此的认识。
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