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一家三级护理中心在新冠疫情期间管理小儿气管支气管异物的经验。

A Tertiary Care Centre Experience on the Management of Paediatric Tracheobronchial Foreign Body During the COVID 19 Pandemic.

作者信息

Hameed Shaul, Reddy Y Mounika

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, Govt. ENT hospital, Osmania Medical College, Hyderabad, 500095 India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):3473-3480. doi: 10.1007/s12070-021-02880-7. Epub 2021 Oct 5.

Abstract

Tracheobronchial foreign body aspiration (FBA) is a life threatening emergency most commonly seen among paediatric age group that requires immediate therapeutic intervention. The purpose of this study is to report our experience on management of these aspirated foreign body (FB) with rigid bronchoscopy during the COVID 19 pandemic. This is a retrospective study which included 100 children less than 17 years of age, diagnosed with suspected FBA and underwent rigid bronchoscopy for its removal between March 2020 and March 2021. Guardians of all female children with history of FBA, had to go through medicolegal enquiry considering the possibility of female infanticide. Analysis of data was made of the demographic details, characteristics and location of the aspirated FB, treatment modalities and difficulties encountered. Among the 100 patients included in the study, 67% were under 3 years of age. The male to female ratio was 2.23:1. 69% of the FB's were most frequently found in the right main bronchus. 63 cases of the removed FB were organic materials such as nuts. Tracheobronchial FB's should be suspected in children who have sudden onset of cough and respiratory distress, even when physical and radiographic evidence is absent. Mortality due to FBA is preventable by early intervention with bronchoscopy. During the Covid 19 pandemic before performing any emergency procedure, prior preoperative planning and use of personal protective equipment is important, considering the very high risk of transmission of the virus due to aerosol generation.

摘要

气管支气管异物吸入(FBA)是一种危及生命的紧急情况,在儿童年龄组中最为常见,需要立即进行治疗干预。本研究的目的是报告我们在新冠疫情期间使用硬质支气管镜处理这些吸入性异物(FB)的经验。这是一项回顾性研究,纳入了100名17岁以下被诊断为疑似FBA并在2020年3月至2021年3月期间接受硬质支气管镜异物取出术的儿童。所有有FBA病史的女童监护人,由于存在杀女婴的可能性,都必须接受法医学调查。对人口统计学细节、吸入异物的特征和位置、治疗方式及遇到的困难进行了数据分析。在纳入研究的100例患者中,67%年龄在3岁以下。男女比例为2.23:1。69%的异物最常出现在右主支气管。取出的异物中有63例是坚果等有机物质。即使没有体格检查和影像学证据,对于突然出现咳嗽和呼吸窘迫的儿童也应怀疑气管支气管异物。通过早期支气管镜干预可预防FBA导致的死亡。在新冠疫情期间,在进行任何紧急手术前,考虑到由于产生气溶胶而导致病毒传播的极高风险,术前进行规划和使用个人防护设备非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6d4/9702447/dca4c10ae749/12070_2021_2880_Fig1_HTML.jpg

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