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急诊科对耳鼻喉科异物的处理是否成功?澳大利亚一家三级护理医院的经验。

Is the emergency department management of ENT foreign bodies successful? A tertiary care hospital experience in Australia.

作者信息

Gupta Ritesh, Nyakunu Rugare Percy, Kippax Jorian Russell

机构信息

, Department of ENT, Princess Marina Hospital, Gaborone, Botswana.

出版信息

Ear Nose Throat J. 2016 Mar;95(3):113-6.

Abstract

We evaluated the role of the emergency department (ED) in the management of ear, nose, and throat foreign bodies in an Australian tertiary care hospital. We retrospectively reviewed all cases of ENT foreign-body presentations in the ED over a 2-year period. We identified 168 such cases, a large proportion of which involved pediatric patients. In addition to demographic factors, we also collected data on the nature of the foreign bodies, the specific sites involved, the rate of successful treatment by the ED staff, the seniority/rank of the treating clinician, and complications. Foreign bodies in the ear accounted for 49% of all cases, the nose for 43%, and the throat for 8%. The ED staff attempted to remove the foreign body in 89% of cases, while the rest were referred to the ENT team. The rate of successful removal of all foreign bodies attempted by the ED team was fairly high-78%; success rates were 86% for nasal foreign bodies, 72% for aural objects, and 67% for those lodged in the throat. No major complications occurred; minor bleeding episodes after removal occurred in 8% of cases. Most ENT foreign-body presentations were managed safely and entirely by the ED team; most of the ENT referrals were to outpatient clinics.

摘要

我们评估了澳大利亚一家三级医疗机构急诊科在处理耳鼻咽喉异物方面的作用。我们回顾性分析了两年期间急诊科所有耳鼻咽喉异物就诊病例。我们确定了168例此类病例,其中很大一部分涉及儿科患者。除了人口统计学因素外,我们还收集了关于异物性质、具体受累部位、急诊科工作人员成功治疗率、治疗临床医生的资历/职级以及并发症的数据。耳部异物占所有病例的49%,鼻部占43%,喉部占8%。急诊科工作人员在89%的病例中尝试取出异物,其余病例则转诊至耳鼻喉科团队。急诊科团队尝试取出的所有异物的成功取出率相当高,为78%;鼻异物的成功率为86%,耳异物为72%,喉部异物为67%。未发生重大并发症;8%的病例在取出后出现轻微出血情况。大多数耳鼻咽喉异物就诊病例由急诊科团队安全且完全地处理;大多数耳鼻喉科转诊是至门诊诊所。

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