Budhiraja Grace, Singh Harsimrat, Guram Danish, Kaur Navjot
Department of Otolaryngology, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab 151001 India.
Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):6448-6454. doi: 10.1007/s12070-020-02297-8. Epub 2021 Jan 3.
Immediate removal of foreign body (FB) can minimize the rate of complications. In the present study, we evaluated different types of foreign bodies, presenting clinical features amongst the children and their site of impaction. We also evaluated the anesthetic considerations during ventilation of pediatric airway in such Foreign body aspiration (FBA) patients. A retrospective study, for which prior Institutional Research Committee approval was taken, was conducted in 50 patients admitted in a tertiary care health centre. Relevant history regarding each patient's presenting symptoms or symptoms prior to hospitalization were recorded with special focus on interval between inhalation of foreign body and food intake. Each patient was examined for the nature and site of the foreign body. Appropriate method of ventilation for each case was discussed with the anesthesiologist before hand. Results of both therapeutic and diagnostic bronchoscopy were detailed. Majority of patients with foreign body aspiration (44%) were male children, between 1 and 3 years of age. The clinical features were mainly cough, respiratory distress and wheeze. Organic FB (73.9%) were the most common type of foreign body found. Right bronchus (64%) was the most common site of aspiration followed by left bronchus (24%). Jet ventilation was used in all the children, and duration of the rigid bronchoscopy was less than 15 min in majority of the cases. FBA are still dreaded as one of the leading causes of morbidity and mortality in infants and children that can be prevented by early diagnosis and management.
立即取出异物可将并发症发生率降至最低。在本研究中,我们评估了不同类型的异物、儿童的临床表现及其嵌顿部位。我们还评估了此类异物吸入(FBA)患者小儿气道通气期间的麻醉注意事项。在一家三级医疗保健中心对50例入院患者进行了一项回顾性研究,该研究事先获得了机构研究委员会的批准。记录了每位患者的当前症状或住院前症状的相关病史,特别关注异物吸入与进食之间的间隔时间。对每位患者进行了异物性质和部位的检查。事先与麻醉师讨论了每种情况的适当通气方法。详细记录了治疗性和诊断性支气管镜检查的结果。大多数异物吸入患者(44%)为1至3岁的男童。临床特征主要为咳嗽、呼吸窘迫和喘息。有机异物(73.9%)是最常见的异物类型。右支气管(64%)是最常见的吸入部位,其次是左支气管(24%)。所有儿童均采用喷射通气,大多数病例的硬质支气管镜检查持续时间少于15分钟。异物吸入仍然是婴幼儿发病和死亡的主要原因之一,可通过早期诊断和处理来预防。