Zhong Bing, Sun Si-Lu, Du Jin-Tao, Deng Di, Liu Feng, Liu Ya-Feng, Shi-Xi Liu, Chen Fei
Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University.
State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
Medicine (Baltimore). 2019 Mar;98(10):e14655. doi: 10.1097/MD.0000000000014655.
The aim of this study was to determine the risk factors for lower respiratory tract infection (LRTI) in children caused by tracheobronchial foreign body aspiration (TFBA).A total of 351 patients were retrospectively reviewed; all patients were diagnosed with TFBA at West China Hospital of Sichuan University from 2015 to 2017. Univariate analyses and multivariate analysis were used.Age (<2 years) (P < .001), type of foreign body (plant) (P < .001), shape of foreign body (nonsmooth) (P < .001), and residence time of foreign body (>7 days) (P = .001) were risk factors for LRTI on univariate analysis. Multivariate analysis showed age (<2 years) (hazard ratio [HR] = 4.457; 95% confidence interval [CI] = 2.031-6.884; P < .001), type of foreign body (plant) (HR = 2.686; 95% CI = 1.577-3.452; P < .001), shape of foreign body (nonsmooth) (HR = 1.649; 95% CI = 1.437-3.663; P < .008), and residence time of foreign body (>7 days) (HR = 1.751; 95% CI = 1.329-3.554; P = .004) were independent risk factors for LRTI. Furthermore, children with LRTI also had longer lengths of hospital stays and antibiotic use than did children without LRTI.Age, plant foreign body, nonsmooth foreign body, and long-term incarceration were all independent risk factors for LRTI in children. These results can help us to select more appropriate intervention times and stratified treatment for children with TFBA.
本研究旨在确定气管支气管异物吸入(TFBA)所致儿童下呼吸道感染(LRTI)的危险因素。回顾性分析了351例患者;所有患者均于2015年至2017年在四川大学华西医院被诊断为TFBA。采用单因素分析和多因素分析。单因素分析显示,年龄(<2岁)(P<0.001)、异物类型(植物)(P<0.001)、异物形状(不光滑)(P<0.001)和异物停留时间(>7天)(P=0.001)是LRTI的危险因素。多因素分析显示,年龄(<2岁)(风险比[HR]=4.457;95%置信区间[CI]=2.031-6.884;P<0.001)、异物类型(植物)(HR=2.686;95%CI=1.577-3.452;P<0.001)、异物形状(不光滑)(HR=1.649;95%CI=1.437-3.663;P<0.008)和异物停留时间(>7天)(HR=1.751;95%CI=1.329-3.554;P=0.004)是LRTI的独立危险因素。此外,与无LRTI的儿童相比,LRTI儿童的住院时间和抗生素使用时间也更长。年龄、植物性异物、不光滑异物和长期嵌顿均是儿童LRTI的独立危险因素。这些结果有助于我们为TFBA儿童选择更合适的干预时机和分层治疗。