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可弯曲纤维支气管镜在小儿气道异物诊断和治疗中的作用:伊朗一家三级护理医院的5年经验

Role of Flexible Fiberoptic Bronchoscopy in the Diagnosis and Treatment of Pediatric Airway Foreign Bodies: A 5-Year Experience at a Tertiary Care Hospital in Iran.

作者信息

Turk Danial, Moslehi Mohammad Ashkan, Hosseinpour Hamidreza

机构信息

School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Pediatric Interventional Pulmonology Division, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Tanaffos. 2022 Mar;21(3):354-361.

Abstract

BACKGROUND

Foreign body aspiration can be a life-threatening incidence amongst children. The aim of this study was to evaluate the usefulness and outcomes of foreign body removal with emphasis on accuracy of flexible fiberoptic bronchoscopy and the predictors of post-procedure complications in children.

MATERIALS AND METHODS

Records of patients who had undergone flexible fiberoptic bronchoscopy for foreign body extraction in Namazi Hospital affiliated to Shiraz University of Medical Sciences from 2012 to 2017 were retrospectively reviewed.

RESULTS

109 patients in whom foreign body were detected by flexible fiberoptic bronchoscopy were enrolled. The patients' age range was between 10 days to 16 years, with the male predominance and the peak incidence amongst toddlers aged 1 to 2 years. The majority of foreign body were situated in the left main bronchus (22.9%). Coughing (37.5%) and chocking (20.8%) were the most commonly recorded symptoms. Hyperinflation (63.5%) and lung collapse (19.2%) were the most radiological findings. The duration of the procedure for 50.5% of the patients was 5-8 minutes. No complications were recorded during the flexible fiberoptic bronchoscopy procedure. Ninety-five percent of the patients had more than one visit before their admission for bronchoscopy with incorrect diagnosis of asthma/reactive airway disease and pneumonia, 74 and 20%, respectively.

CONCLUSION

Although rigid bronchoscopy is still considered as the gold standard and preferred method in managing the airways foreign bodies, flexible fiberoptic bronchoscopy also can be used as an effective diagnostic and therapeutic tool with high success.

摘要

背景

异物吸入在儿童中可能是危及生命的事件。本研究的目的是评估异物取出的有效性和结果,重点是儿童柔性纤维支气管镜检查的准确性以及术后并发症的预测因素。

材料与方法

回顾性分析2012年至2017年在设拉子医科大学附属纳马齐医院接受柔性纤维支气管镜异物取出术的患者记录。

结果

纳入109例经柔性纤维支气管镜检查发现异物的患者。患者年龄范围为10天至16岁,以男性为主,1至2岁幼儿发病率最高。大多数异物位于左主支气管(22.9%)。咳嗽(37.5%)和窒息(20.8%)是最常记录的症状。肺过度充气(63.5%)和肺不张(19.2%)是最常见的影像学表现。50.5%的患者手术持续时间为5至8分钟。柔性纤维支气管镜检查过程中未记录并发症。95%的患者在因哮喘/反应性气道疾病和肺炎诊断错误而入院接受支气管镜检查之前有不止一次就诊,分别为74%和20%。

结论

尽管硬支气管镜检查仍被视为处理气道异物的金标准和首选方法,但柔性纤维支气管镜检查也可作为一种有效的诊断和治疗工具,成功率很高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e12/10073951/49b8d8c4e6a9/Tanaffos-21-354-g001.jpg

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