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成人全身麻醉下支气管镜取出气道异物:38例分析

Extraction of airway foreign bodies with bronchoscopy under general anesthesia in adults: an analysis of 38 cases.

作者信息

Wang Yuling, Wang Juan, Pei Yinghua, Qiu Xiaojian, Wang Ting, Xu Min, Zhang Jie

机构信息

Department of Respiratory and Critical Care, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China.

出版信息

J Thorac Dis. 2020 Oct;12(10):6023-6029. doi: 10.21037/jtd-20-2903.

Abstract

BACKGROUND

To explore the efficacy and safety of extracting airway foreign bodies with bronchoscopy under general anesthesia in adults.

METHODS

Altogether, 38 adult patients who underwent airway foreign body extraction with bronchoscopy under general anesthesia in the Pneumology Department of Beijing Tiantan Hospital, Capital Medical University, from January 2005 to December 2014 were included in the study and retrospectively analyzed concerning the extraction methods and complications. The indications and experience and lessons were summarized.

RESULTS

In 38 patients with general anesthesia who had foreign bodies removed by bronchoscopy, 1 case failed to be removed, and 37 cases were successfully removed, with a success rate of 97.4%. One of the patients failed to remove the foreign body due to massive hemorrhage during the resection of the right middle bronchial stone, and the operation was interrupted. Blood loss was analyzed in all patients, 4 patients (10.5%) lost blood greater than 10 mL, and 1 patient (2.63%) lost blood greater than 300 mL. To analyze the status of airway injury, 3 patients (7.9%) had local airway mucosal tearing, and 1 patient had mild glottis edema. All the patients in this group had silent portal injury, severe hypoxemia or asphyxia, and no complications such as pneumothorax, mediastinal emphysema or pulmonary edema occurred.

CONCLUSIONS

Extraction of airway foreign bodies with bronchoscopy under general anesthesia in adults is safe and effective and can avoid surgical treatment in some patients.

摘要

背景

探讨全身麻醉下经支气管镜取出成人气道异物的有效性和安全性。

方法

纳入2005年1月至2014年12月在首都医科大学附属北京天坛医院呼吸内科接受全身麻醉下经支气管镜气道异物取出术的38例成年患者,对其取出方法及并发症进行回顾性分析,总结适应证及经验教训。

结果

38例全身麻醉下行支气管镜异物取出术的患者中,1例取出失败,37例成功取出,成功率为97.4%。其中1例患者因右中支气管结石切除术中大出血导致异物取出失败,手术中断。分析所有患者的出血量,4例(10.5%)出血量大于10 mL,1例(2.63%)出血量大于300 mL。分析气道损伤情况,3例(7.9%)出现局部气道黏膜撕裂,1例出现轻度声门水肿。该组患者均未出现隐匿性门脉损伤、严重低氧血症或窒息,也未发生气胸、纵隔气肿或肺水肿等并发症。

结论

全身麻醉下经支气管镜取出成人气道异物安全有效,可避免部分患者的手术治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55b9/7656387/64d37e43ed19/jtd-12-10-6023-f1.jpg

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