Cohen Shlomo, Goldberg Shmuel, Springer Chaim, Avital Avraham, Picard Elie
Harefuah. 2015 Mar;154(3):175-7, 211.
Foreign body (FB) aspiration occurs mainly in children under 3 years of age and is one of the most frequent causes of accidental death under 12 months of age. The increased risk of FB aspiration in children is due to the different structure of the pharynx and the upper airways compared to adults. In addition, children have an immature swallowing mechanism and they most commonly aspirate food stuffs. FB aspiration is usually a sudden and dramatic event when the child feels that he is suffocating or choking. After the acute event, the clinical presentation widely ranges from severe respiratory distress to the most minimal symptoms. Bronchoscopy is the best diagnostic and therapeutic modality for FB inhalation. Prevention and rapid diagnosis can be lifesaving. In 2010, the American Academy of Pediatrics published a position paper on prevention of FB aspiration. The association calls for more proactive preventative measures to protect children from FB aspiration and to prevent mortality and morbidity. These include: 1. Raising awareness of parents and caregivers to supervise children and create a safe environment for them. 2. Promoting legislation and enforcing regulations that will prevent dangerous products being sold for children. 3. Changing the design of products, especially food products and toys, that will reduce the risks of choking. In this overview we will show the principles of diagnosis of FB aspiration and a flow chart including when flexible or rigid bronchoscopy is required.
异物吸入主要发生在3岁以下儿童中,是12个月以下儿童意外死亡的最常见原因之一。与成人相比,儿童异物吸入风险增加是由于其咽部和上呼吸道结构不同。此外,儿童吞咽机制不成熟,最常吸入食物。当儿童感觉自己窒息或噎住时,异物吸入通常是一个突然且严重的事件。急性事件发生后,临床表现范围广泛,从严重呼吸窘迫到最轻微的症状。支气管镜检查是异物吸入的最佳诊断和治疗方式。预防和快速诊断可挽救生命。2010年,美国儿科学会发表了一篇关于预防异物吸入的立场文件。该协会呼吁采取更积极的预防措施,保护儿童免受异物吸入,并预防死亡和发病。这些措施包括:1. 提高家长和照顾者的意识,监督儿童并为他们创造安全的环境。2. 推动立法并执行相关规定,防止向儿童出售危险产品。3. 改变产品设计,特别是食品和玩具,以降低窒息风险。在本综述中,我们将展示异物吸入的诊断原则以及包括何时需要进行柔性或刚性支气管镜检查的流程图。