Yan Yangyan, Bi Jing, Liu Jia, Tao Xiaofen, Fu Yong
Department of Otolaryngology Head and Neck Surgery，Children's Hospital，Zhejiang University School of Medicine，National Clinical Research Center For Child Health，Hangzhou，310005，China.
Department of Endoscopy Center，Children's Hospital，Zhejiang University School of Medicine，National Clinical Research Center For Child Health.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 Feb;38(2):155-159. doi: 10.13201/j.issn.2096-7993.2024.02.014.
To explore the diagnosis and treatment experience of complex respiratory foreign bodies in children. The clinical data of 1 243 cases of respiratory foreign bodies in children were retrospectively analyzed, among which 10 cases（0.8%） were complicated respiratory foreign bodies. Among the 10 cases of complex respiratory foreign bodies, 2 cases were removed by open thoracotomy, 1 case was removed by tracheotomy, 1 case was removed by lobectomy, 1 case was removed by fiberoptic bronchoscopy because of difficult airway caused by the accompanying congenital pulmonary artery sling, and the pulmonary artery sling correction was synchronized with the fiberoptic bronchoscopic removal, 3 cases were removed by fiberoptic bronchoscopic holmium laser and/or freezing method to make the foreign body deformed and fragmented and then taken out by the sound gate, and 2 cases were removed because of the In 3 cases, the foreign bodies were deformed and fragmented by fiberoptic bronchoscopy, and in 2 cases, the foreign bodies were removed through the vocal folds because of their special characteristics. Two cases were intubated and sent to ICU after surgery because of obvious vocal edema and difficulty in deoxygenation, two cases were transferred to ICU after cardiac or thoracic surgery, and the rest of them returned to ordinary wards after surgery, and all 10 cases recovered well after surgery. Respiratory foreign body combined with airway stenosis, when the foreign body type, shape, embedded location of special foreign body, foreign body is too large, need to rationally choose the method of foreign body removal. If necessary, a combination of methods can be used to ensure that the airway obstruction is quickly relieved with the best program.
探讨儿童复杂呼吸道异物的诊治经验。回顾性分析1243例儿童呼吸道异物的临床资料，其中10例（0.8%）为复杂呼吸道异物。在10例复杂呼吸道异物中，2例行开胸手术取出，1例行气管切开取出，1例行肺叶切除取出，1例因合并先天性肺动脉吊带致气道困难行纤维支气管镜取出，同期行肺动脉吊带矫治，3例行纤维支气管镜钬激光和/或冷冻法使异物变形破碎后经声门取出，2例因异物特殊经纤维支气管镜使异物变形破碎，2例经声门取出。2例术后因声门明显水肿、脱氧困难行气管插管送ICU，2例心脏或胸科手术后转ICU，其余术后返回普通病房，10例术后均恢复良好。呼吸道异物合并气道狭窄时，当异物种类、形状、特殊异物嵌顿部位、异物过大时，需合理选择异物取出方法。必要时可联合多种方法，以最佳方案确保迅速解除气道梗阻。
