气管支气管异物的内镜取出术：51例儿科患者的治疗结果
Endoscopic removal of tracheobronchial foreign bodies: results on a series of 51 pediatric patients.
作者信息
De Palma Angela, Brascia Debora, Fiorella Angela, Quercia Rosatea, Garofalo Giuseppe, Genualdo Marcella, Pizzuto Ondina, Costantino Michele, Simone Valentina, De Iaco Giulia, Nex Giulia, Maiolino Elena, Schiavone Marcella, Signore Francesca, Panza Teodora, Cardinale Fabio, Marulli Giuseppe
机构信息
Department of Emergency and Organ Transplantation, Thoracic Surgery Unit, University Hospital of Bari, G. Cesare Square, 11, 70124, Bari, Italy.
Department of Pediatrics, Pediatric Unit, Giovanni XXIII Hospital of Bari, 70126 BA, Bari, Italy.
出版信息
Pediatr Surg Int. 2020 Aug;36(8):941-951. doi: 10.1007/s00383-020-04685-1. Epub 2020 May 28.
PURPOSE
Rigid bronchoscopy (RB) is still considered the gold standard approach for the removal of airway foreign bodies (FBs) in children; however, flexible bronchoscopy (FOB) has recently been proposed both as diagnostic and therapeutic means. Our purpose was to evaluate the outcomes of FOB, associated with the Dormia basket, for the removal of FBs.
METHODS
Retrospective data about 124 children who underwent bronchoscopy for the suspicion of a FB aspiration between January 2008 and January 2019 in our department were collected.
RESULTS
In a total of 51 cases, FBs were removed through FOB or RB associated with forceps or Dormia basket. Male to female ratio was 1.8:1, mean age 30 ± 26.1 months. Thirty-four (67%) FBs were directly removed through FOB, in most of the cases using Dormia basket and twelve (23%) patients underwent RB. The overall left-versus-right distribution was 57% vs. 43%. The mean retrieval procedural time was 36.29 ± 24.99 min for FOB and 52.5 ± 29.74 min for RB; the success rate of the procedures was 97% vs. 67%.
CONCLUSION
FOB can be used not only as a diagnostic procedure, but also as the first method for the removal of airway FBs. The Dormia basket is a useful tool, especially to remove peripherally located FBs.
目的
硬质支气管镜检查（RB）仍被认为是儿童气道异物（FBs）取出术的金标准方法；然而，最近有人提出将可弯曲支气管镜检查（FOB）作为诊断和治疗手段。我们的目的是评估与多尔米亚篮配合使用的FOB在取出FBs方面的效果。
方法
收集了2008年1月至2019年1月期间在我科因怀疑有FB吸入而接受支气管镜检查的124例儿童的回顾性数据。
结果
总共51例病例中，通过与钳子或多尔米亚篮配合使用的FOB或RB取出了FBs。男女比例为1.8:1，平均年龄30±26.1个月。34例（67%）FBs通过FOB直接取出，大多数情况下使用多尔米亚篮，12例（23%）患者接受了RB。左右分布总体为57%对43%。FOB的平均取出操作时间为36.29±24.99分钟，RB为52.5±29.74分钟；操作成功率分别为97%和67%。
结论
FOB不仅可以用作诊断程序，还可以作为气道FBs取出的首选方法。多尔米亚篮是一种有用的工具，特别是用于取出周边位置的FBs。
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