Sancho-Chust Jose N, Molina Virginia, Vañes Sandra, Pulido Ana M, Maestre Lia, Chiner Eusebi
Secció de Pneumologia, Hospital Universitari Sant Joan d'Alacant, Ctra Alacant-València s/n, 03550 Sant Joan d'Alacant, Spain.
J Clin Med. 2020 May 10;9(5):1409. doi: 10.3390/jcm9051409.
Foreign body aspiration is relatively infrequent in adults. Airway foreign bodies (AFBs) can be removed by flexible bronchoscopy (FB) or rigid bronchoscopy (RB). We performed a retrospective analysis of FBs performed in our centre over a 25 year period, focusing on the procedures that revealed an AFB during the examination stage. We recorded demographic data, clinical characteristics and radiological and bronchoscopic findings. During the study period, 12,588 FBs were performed in adults. Airway foreign bodies were identified in 32 of these cases, giving a prevalence of 0.25%. The most frequent clinical presentation was cough, sputum and fever. The most frequent radiological findings were alveolar infiltrates and atelectasis. In 94% of cases, AFBs were removed successfully by FB; RB was necessary in only 6% of cases. There were no FB-related complications. The most common AFB location was the right bronchial tree (69%). We classified AFBs as organic (85%: animal 57%; vegetable 28%), inorganic (6%) and iatrogenic (9%). Bronchial infection occurred in 51% of cases, and spp. was the most common causal microorganism. In conclusion, AFBs are a rare entity with nonspecific clinical presentation, most AFBs were organic, and FB is a safe and effective method for AFB removal.
成人气道异物吸入相对较少见。气道异物（AFB）可通过可弯曲支气管镜检查（FB）或硬质支气管镜检查（RB）取出。我们对本中心25年间进行的可弯曲支气管镜检查进行了回顾性分析，重点关注在检查阶段发现气道异物的操作。我们记录了人口统计学数据、临床特征以及放射学和支气管镜检查结果。在研究期间，共对成人进行了12588次可弯曲支气管镜检查。其中32例发现气道异物，患病率为0.25%。最常见的临床表现是咳嗽、咳痰和发热。最常见的放射学表现是肺泡浸润和肺不张。94%的病例通过可弯曲支气管镜检查成功取出气道异物；仅6%的病例需要硬质支气管镜检查。未发生与可弯曲支气管镜检查相关的并发症。气道异物最常见的位置是右支气管树（69%）。我们将气道异物分为有机性（85%：动物性57%；植物性28%）、无机性（6%）和医源性（9%）。51%的病例发生支气管感染， 菌是最常见的致病微生物。总之，气道异物是一种临床表现不特异的罕见情况，大多数气道异物为有机性，可弯曲支气管镜检查是取出气道异物的一种安全有效的方法。
