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儿童异物吸入:治疗时机和相关并发症。

Foreign body aspiration in children: Treatment timing and related complications.

机构信息

Division of Pediatric Surgery & Pediatric Airway Unit, Hospital U, 12 de Octubre, Madrid, Spain; Universidad Complutense de Madrid, Spain.

Division of Pediatric Surgery, Hospital U. 12 de Octubre, Madrid, Spain.

出版信息

Int J Pediatr Otorhinolaryngol. 2021 May;144:110690. doi: 10.1016/j.ijporl.2021.110690. Epub 2021 Mar 26.

Abstract

BACKGROUND/PURPOSE: The aims of this study were to describe our experience in the management of FB aspiration in children, focusing on the eventual association between delay in treatment and the development of complications, and to determine if the incidence of this emergency had decreased in the last 10 years.

METHODS

Retrospective study of children with a diagnosis of FB aspiration managed between 1999 and 2019 at a tertiary care referral hospital. The following data were collected: demographics, clinical presentation, radiological findings, endoscopic technique, type of FB, time elapsed between the aspiration episode and treatment, and complications. Main outcome measures were the rate of complications (intraoperative and long-term) in the cohort of patients with delay in treatment (>72 h), and the incidence of FB aspiration in each of the two historical subgroups of the study.

RESULTS

The study included 130 patients, 66.2% male, with a median age of 24 months. Cough was the most frequent symptom (76.1%) and unilateral air trapping was the most common radiological finding (48.8%). Removal of FB was performed with rigid bronchoscopy in every case. The most common type of FB was organic (73%) and located in the right bronchial system (47.7%). The global rate of complications was 16.1%. Patients with a delay in treatment beyond 72 h from the aspiration episode showed a statistically significant risk of developing both intraoperative and postoperative complications. Additionally, we have stated that the incidence of FB aspiration in our community has decreased by 44.4% in the last 10 years.

CONCLUSIONS

The incidence of FB aspiration has remarkably decreased in our environment in the last decade. Delay in treatment placed our patients at a significant higher risk of developing complications both during the bronchoscopic procedure and in the long-term.

摘要

背景/目的:本研究旨在描述我们在儿童 FB 吸入管理方面的经验,重点关注治疗延迟与并发症发展之间的关联,并确定这种紧急情况在过去 10 年中是否有所减少。

方法

回顾性研究 1999 年至 2019 年期间在一家三级转诊医院接受诊断为 FB 吸入治疗的儿童。收集以下数据:人口统计学、临床表现、影像学发现、内镜技术、FB 类型、吸入事件与治疗之间的时间间隔以及并发症。主要观察指标是治疗延迟(>72 小时)患者亚组中并发症(术中及长期)的发生率,以及研究中两个历史亚组中 FB 吸入的发生率。

结果

该研究纳入了 130 例患者,其中男性占 66.2%,中位年龄为 24 个月。咳嗽是最常见的症状(76.1%),单侧空气滞留是最常见的影像学发现(48.8%)。所有病例均采用硬支气管镜取出 FB。最常见的 FB 类型为有机(73%),位于右支气管系统(47.7%)。总体并发症发生率为 16.1%。从吸入到治疗超过 72 小时的患者发生术中及术后并发症的风险显著增加。此外,我们还发现,在过去 10 年中,我们社区的 FB 吸入发生率下降了 44.4%。

结论

在过去的十年中,我们的环境中 FB 吸入的发生率显著下降。治疗延迟使我们的患者在支气管镜检查过程中和长期内发生并发症的风险显著增加。

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