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儿童支气管异物的延迟诊断和外科治疗。

Delayed diagnosis and surgical treatment of bronchial foreign body in children.

机构信息

Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China; National Clinical Research Center for Child Health and Disorders, Chongqing, China; Chongqing Key Laboratory of Pediatrics, Chongqing, China.

Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China; National Clinical Research Center for Child Health and Disorders, Chongqing, China; Chongqing Key Laboratory of Pediatrics, Chongqing, China.

出版信息

J Pediatr Surg. 2020 Sep;55(9):1860-1865. doi: 10.1016/j.jpedsurg.2019.10.052. Epub 2019 Nov 9.

Abstract

BACKGROUND

Delayed diagnosis of children with Bronchial Foreign Body (BFB) leads to significant pulmonary complications and open surgery may not be avoided. However, surgical management for children with BFB is rarely reported. This study aims to describe our experience in the diagnosis and surgical treatment of late-diagnosed BFB during childhood.

METHODS

Medical records of 8 children who were diagnosed with BFB and underwent open surgery at Children's Hospital of Chongqing Medical University between January 2004 and June 2019 were retrospectively reviewed.

RESULTS

This group consisted of 8 children, with an average age of 8.1 years. In this group, the typical aspiration history was absent and the diagnosis of BFB was established in delay. The onset of diseases varied from 2 months to over 4 years. Lobectomy was performed in 7 patients and pneumonotomy was performed in 1 patient. No postoperative death was found. The clinical outcomes were satisfactory with an average 33 months follow-up.

CONCLUSIONS

The diagnosis of BFB should be considered in children who present with repeated pneumonia and agnogenic bronchiectasis and actelectasis despite repeated medical treatment. Surgical treatment is necessary and effective in patients with either unextractable BFB or irreversible damage of lung tissue.

LEVELS OF EVIDENCE

Level IV.

TYPE OF STUDY

Retrospective study.

摘要

背景

儿童支气管异物(BFB)的诊断延迟会导致严重的肺部并发症,可能需要进行开放性手术。然而,针对儿童 BFB 的手术治疗方法却鲜有报道。本研究旨在描述我们在儿童时期诊断和治疗迟发性 BFB 的经验。

方法

回顾性分析 2004 年 1 月至 2019 年 6 月期间在重庆医科大学儿童医院接受开放性手术治疗的 8 例 BFB 患儿的病历资料。

结果

该组患儿共 8 例,平均年龄 8.1 岁。本组患儿均无典型异物吸入史,且存在 BFB 诊断延迟。发病时间从 2 个月至 4 年以上不等。7 例患儿行肺叶切除术,1 例患儿行肺切开术。术后无死亡病例。平均随访 33 个月,临床结果满意。

结论

对于反复肺炎和不明原因支气管扩张症及肺不张患儿,即使经过多次治疗仍无效,应考虑 BFB 的诊断。对于无法取出的 BFB 或肺组织不可逆损伤的患者,手术治疗是必要且有效的。

证据水平

IV 级。

研究类型

回顾性研究。

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