First Department of Pediatrics, Aghia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Evelina London Children's Hospital, London, UK.
Acta Paediatr. 2022 Jul;111(7):1301-1312. doi: 10.1111/apa.16351. Epub 2022 Apr 12.
Our aim was to summarise the evidence about flexible bronchoscopy for paediatric airway foreign body aspiration cases.
We searched the PubMed database from 1 January 2001 to 9 October 2021 for peer-review papers published in English on the use, and success rates, of flexible bronchoscopy as the first-line treatment for foreign body aspiration cases. This process identified 243 potential papers.
We studied 23 papers comprising 2588 cases of foreign body aspiration and flexible bronchoscopy successfully removed the foreign bodies in 87.1% of cases. Complication rates were low in the 983 patients studied in 18 papers. The foreign bodies were organic materials in 78.3% of 1371 patients and mainly lodged in the right bronchial tree in 50.5% of 1402 patients. General anaesthesia was used before flexible bronchoscopy in 14/23 studies and laryngeal mask airways were mostly used in 10/23 studies to secure the airway during the procedure. Ancillary equipment was used to assist the foreign body removal in 57.3% of 1808 cases and these were usually baskets.
Flexible bronchoscopy was a feasible and safe therapeutic procedure for selected foreign body aspiration cases. Future studies need to focus on comparing the clinical outcomes of flexible and rigid bronchoscopies.
总结儿童气道异物吸入病例中使用软性支气管镜的证据。
我们检索了 2001 年 1 月 1 日至 2021 年 10 月 9 日发表的英文同行评审文献，以了解软性支气管镜作为异物吸入病例一线治疗的使用情况和成功率。这一过程确定了 243 篇潜在文献。
我们研究了 23 篇论文，这些论文共包括 2588 例异物吸入病例，软性支气管镜成功取出异物的比例为 87.1%。在 18 篇论文中研究的 983 例患者中，并发症发生率较低。在 1371 例患者中，异物为有机材料的比例为 78.3%，在 1402 例患者中，异物主要位于右支气管树的比例为 50.5%。在 23 项研究中的 14 项研究中，软性支气管镜检查前使用全身麻醉，在 23 项研究中的 10 项研究中，使用喉罩气道在手术过程中确保气道通畅。在 1808 例病例中，57.3%的病例使用了辅助设备来协助异物取出，这些设备通常是篮子。
软性支气管镜检查是一种可行且安全的治疗方法，适用于选择的异物吸入病例。未来的研究需要集中比较软性和硬性支气管镜的临床结果。
