Masuda Atsunori, Asano Fumihiro, Tsuzuku Akifumi, Sobajima Takuya, Murakami Anri, Matsuno Yoshihiko, Hirata Kazuhiro, Matsunami Kunihiro, Imamura Atsushi
Department of Pulmonary Medicine, Gifu Prefectural General Medical Center, Japan.
Intern Med. 2015;54(5):497-502. doi: 10.2169/internalmedicine.54.3027. Epub 2015 Jan 15.
The patient was a 5-year-old boy who was transported to our hospital for a paroxysmal cough, disturbance of consciousness, tonic-clonic convulsions and labored breathing. The patient's respiratory failure persisted after the convulsions remitted, and the presence of an endobronchial foreign body was suspected based on the findings of chest CT performed the following day. A peanut was subsequently removed from the right main bronchus using a bronchoscope with tracheal intubation and bag valve mask ventilation. Immediately after removal, the patient rapidly developed exacerbated hypoxemia, and a reduction in right lung lucency was noted on chest radiography. He was therefore diagnosed with type II postobstructive pulmonary edema, and his condition improved within a short period of time.
该患者是一名5岁男孩,因阵发性咳嗽、意识障碍、强直阵挛性惊厥和呼吸费力被送往我院。惊厥缓解后患者的呼吸衰竭仍持续存在,根据次日胸部CT检查结果怀疑存在支气管内异物。随后使用带气管插管和袋阀面罩通气的支气管镜从右主支气管取出一颗花生。取出后患者立即迅速出现低氧血症加重,胸部X线检查显示右肺透亮度降低。因此,他被诊断为II型阻塞性肺水肿,且病情在短时间内得到改善。