Reyad Heba M, El-Deeb Mohamed E, Abbas Ahmed M, Sherief Dalia, Elagamy Osama A
Department of Pediatrics, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt.
Department of Otorhinolaryngology, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt.
J Multidiscip Healthc. 2021 Aug 24;14:2299-2305. doi: 10.2147/JMDH.S326967. eCollection 2021.
Foreign body aspiration (FBA) is a frequent cause of childhood morbidity and mortality. Diagnosis of FBA is challenging in the absence of a witnessed aspiration event. The aim of this study was to determine the accuracy of presenting symptoms as well as physical and radiologic findings as predictors of FBA in children. Thus, indications for bronchoscopy could be determined in such cases.
This retrospective cohort study was conducted in the ENT department, Kafr-elsheikh University Hospital. The medical records of patients younger than 16 years old who underwent rigid bronchoscopy for suspected FBA were included. Data including age, gender, symptoms, physical examination findings, radiological features, nature and location of foreign body, and outcome of the bronchoscopy were collected.
This study included 130 patients, 105 (80.8%) patients were positive for the presence of a foreign body in their airways. Foreign bodies were most frequently (43.8%) lodged in the right main bronchus, and nuts (66.7%), were the most commonly retrieved. Multivariate regression analysis identified the presence of suggestive signs or symptoms as independent predictors of FBA on rigid bronchoscopy.
Objective finding of clinical signs eg unilateral wheezes on chest examination in the presence of symptoms such as a sudden cough, dyspnea, and hoarseness could predict FBA and help physicians in deciding bronchoscopy.
异物吸入(FBA)是儿童发病和死亡的常见原因。在没有目睹吸入事件的情况下,FBA的诊断具有挑战性。本研究的目的是确定作为儿童FBA预测指标的症状表现以及体格检查和影像学检查结果的准确性。因此,在此类病例中可以确定支气管镜检查的指征。
这项回顾性队列研究在卡夫尔谢赫大学医院耳鼻喉科进行。纳入了因疑似FBA接受硬质支气管镜检查的16岁以下患者的病历。收集的数据包括年龄、性别、症状、体格检查结果、影像学特征、异物的性质和位置以及支气管镜检查的结果。
本研究纳入了130例患者,其中105例(80.8%)气道内存在异物。异物最常(43.8%)嵌顿于右主支气管,最常取出的是坚果(66.7%)。多因素回归分析确定,存在提示性体征或症状是硬质支气管镜检查时FBA的独立预测因素。
在出现突然咳嗽、呼吸困难和声音嘶哑等症状时,胸部检查发现单侧哮鸣音等客观临床体征可预测FBA,并有助于医生决定是否进行支气管镜检查。