Center for Respiratory Intervention, Children's Hospital Affiliated to Shandong University, Jinan, China.
Ital J Pediatr. 2022 Sep 2;48(1):159. doi: 10.1186/s13052-022-01347-x.
Along with the wide spread application and technical development of the flexible and rigid bronchoscopy, the airway foreign body removing method cme to the specific technique for different foreign bodies from the single foreign body forceps.
Selected 633 children who were diagnosed as airway foreign bodies by the Department of Respiratory Intervention, Children's Hospital affiliated to Shandong University from January 1st, 2018 to December 31st, 2021, and the airway foreign bodies were diagnosed using bronchoscopy. After comprehensive assessment of the foreign body nature in the airway, the foreign bodies were removed by freezing, laser, electrocoagulation, balloon and other techniques, the success rate of the foreign body removed from the airway was observed, the percentage of the foreign body removed using different techniques, the operation time, and the incidence of post-adverse reactions during operation.
The success rate using flexible bronchoscope alone to remove foreign bodies in the airway was 99.2%. After flexible bronchoscopy, 19 cases of foreign bodies were removed by vacuum suction alone, 513 cases were removed by foreign body forceps alone, 62 cases were combined with cryotherapy, 2 cases were electrocoagulation, 6 cases were mesh baskets, 3 cases were balloons, 5 cases were laser, and various 18 cases of foreign bodies were invloved by technical combination. 5 cases of flexible bronchoscope combined with rigid bronchoscope combined to remove foreign bodies. The operation time was from 5 min to 1 h, with an average of 20 min. There were 17 cases of hypoxemia (2.7%) during operation, 36 cases (5.7%) of bleeding caused by airway mucosa injury after treatment, and 70 cases (11.2%) of laryngeal edema. The total incidence of adverse reactions was 19.6%, there were no deaths due to foreign bodies and treatment.
According to different properties of airway foreign bodies, it is safe and effective to select appropriate techniques to remove foreign bodies using the flexible bronchoscope, which can increase the removal rate of airway foreign bodies and reduce the occurrence of serious complications.
随着软式和硬式支气管镜的广泛应用和技术发展，气道异物清除方法针对不同的异物采用了单一异物钳的特定技术。
选取 2018 年 1 月 1 日至 2021 年 12 月 31 日期间在山东大学附属儿童医院呼吸介入科诊断为气道异物的 633 例患儿，采用支气管镜诊断气道异物。在对气道内异物性质进行全面评估后，采用冷冻、激光、电凝、气囊等技术取出异物，观察异物从气道取出的成功率、不同技术取出异物的百分比、手术时间及术中不良反应发生率。
单纯使用软式支气管镜取出气道异物的成功率为 99.2%。软镜下后单纯使用负压吸引取出异物 19 例，单纯使用异物钳取出异物 513 例，联合冷冻治疗 62 例，电凝 2 例，网篮 6 例，气囊 3 例，激光 5 例，各种技术联合取出异物 18 例。5 例使用软镜联合硬镜联合取出异物。手术时间 5~1 h，平均 20 min。术中低氧血症 17 例（2.7%），气道黏膜损伤治疗后出血 36 例（5.7%），喉水肿 70 例（11.2%）。不良反应总发生率为 19.6%，无因异物及治疗死亡。
根据气道异物的不同性质，选择合适的技术使用软镜安全有效清除异物，可以提高气道异物的清除率，减少严重并发症的发生。
