Department of Otolaryngology-Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China.
Ear Nose Throat J. 2023 Oct;102(10):661-666. doi: 10.1177/01455613211023019. Epub 2021 Jun 10.
To analyze the factors influencing the diagnosis and treatment of tracheobronchial foreign bodies (TFBs) in children.
The clinical data of 300 consecutive children with suspected TFBs who were admitted to our department between January 2016 and December 2019 were retrospectively collected, including demographics, diagnosis, history of foreign body inhalation, preoperative chest computed tomography (CT) findings, duration of foreign body retention, time from admission to operation, operation duration, duration of hospitalization, and complications.
Among the 300 cases, the male:female ratio was 193:107, and the age range was 6 months to 12 years (median age: 19 months). A total of 291 cases (97.0%) involved TFBs confirmed by rigid bronchoscopy, while the other 9 cases (3.0%) involved bronchopneumonia. The diagnostic accuracy, sensitivity, and specificity of a history of foreign body inhalation and chest CT were 96.0%, 98.6%, and 11.1% and 97.7%, 97.6%, and 100%, respectively. The duration of hospitalization, time from admission to operation, and operation duration were all related to bronchopneumonia ( < .05).
A detailed history, adequate physical examination, and preoperative imaging examination help improve the diagnostic accuracy. Preoperative bronchopneumonia in children with TFBs will increase the surgical risks and treatment costs, prolonging the duration of hospitalization.
分析影响儿童气管支气管异物（TFB）诊治的因素。
回顾性收集 2016 年 1 月至 2019 年 12 月期间我科收治的 300 例疑似 TFB 患儿的临床资料，包括人口统计学资料、诊断、异物吸入史、术前胸部 CT 表现、异物留存时间、入院至手术时间、手术时间、住院时间和并发症。
300 例患儿中，男∶女为 193∶107，年龄 6 个月至 12 岁（中位数：19 个月）。291 例（97.0%）经硬支气管镜证实为 TFB，9 例（3.0%）为支气管肺炎。异物吸入史和胸部 CT 的诊断准确率、敏感度、特异度分别为 96.0%、98.6%和 11.1%、97.7%、97.6%和 100%。住院时间、入院至手术时间和手术时间均与支气管肺炎有关（<.05）。
详细的病史、充分的体格检查和术前影像学检查有助于提高诊断准确率。术前支气管肺炎会增加 TFB 患儿的手术风险和治疗费用，延长住院时间。
