小儿气管支气管异物经硬质支气管镜取出困难的危险因素。
Risk factors for difficult removal of tracheobronchial foreign bodies in children by rigid bronchoscopy.
作者信息
Ding Ling, Su Xiujing, Yang Dazhi, Yao Hongbing, Xiao Ling
机构信息
Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
出版信息
Int J Pediatr Otorhinolaryngol. 2023 May;168:111539. doi: 10.1016/j.ijporl.2023.111539. Epub 2023 Mar 26.
OBJECTIVE
To characterize the risk factors for difficult removal of tracheobronchial foreign body (FB) by rigid bronchoscopy in children.
METHODS
We retrospectively analyzed clinical data of 1026 pediatric patients (age: 0-18 years) diagnosed with tracheobronchial FB between September 2018 and August 2021. All patients underwent rigid bronchoscopy as the first intervention at our hospital.
RESULTS
Children aged 1-3 years accounted for 83.7% cases in our cohort. The most common symptoms were cough and wheeze. FBs were more frequently found in the right bronchus, and trachea FBs accounted for only 8.19% cases. The success rate of rigid bronchoscopy in a single attempt was 97.27%. 12.18% of the cases were defined as difficult removal of FB. On univariate analysis, age, CT findings (pneumonia), type of FB, diameter of FB, FB location, granulation tissue formation, and the seniority of the surgeon were identified as risk factors for difficult removal of tracheobronchial FBs. On multivariate analysis, age ≥3 years, FB diameter ≥10 mm, FBs located in left bronchus, multiple FBs, granulation tissue, and the seniority of surgeon (<3 years, ≥5 years) were independent risk factors for difficult removal.
CONCLUSIONS
Age, FB diameter, location of FB, granulation tissue formation, and the seniority of the surgeon were risk factors for difficult removal of FBs by rigid bronchoscopy.
目的
明确儿童经硬质支气管镜取出气管支气管异物（FB）困难的危险因素。
方法
回顾性分析2018年9月至2021年8月期间1026例诊断为气管支气管FB的儿科患者（年龄：0 - 18岁）的临床资料。所有患者在我院均接受硬质支气管镜作为首次干预措施。
结果
在我们的队列中，1 - 3岁儿童占83.7%。最常见的症状是咳嗽和喘息。FB在右支气管中更常见，气管FB仅占8.19%。单次硬质支气管镜检查的成功率为97.27%。12.18%的病例被定义为FB取出困难。单因素分析显示，年龄、CT表现（肺炎）、FB类型、FB直径、FB位置、肉芽组织形成以及外科医生的资历被确定为气管支气管FB取出困难的危险因素。多因素分析显示，年龄≥3岁、FB直径≥10 mm、FB位于左支气管、多个FB、肉芽组织以及外科医生的资历（<3年、≥5年）是取出困难的独立危险因素。
结论
年龄、FB直径、FB位置、肉芽组织形成以及外科医生的资历是经硬质支气管镜取出FB困难的危险因素。
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