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虚拟支气管镜在评估儿童气管支气管树中疑似异物的作用。

Role of Virtual Bronchoscopy in Evaluation of Suspected Foreign Body in Children's Tracheobronchial Tree.

作者信息

Prajapati Rachana M, Raval Jayman B, Aiyer Ranjan G

机构信息

Department of Ear, Nose & Throat and Head and Neck Surgery, GMERS Medical College, Gotri, Vadodara, Gujarat, India.

Department of Ear, Nose & Throat and Head and Neck Surgery, Baroda Medical College, Vadodara, Gujarat, India.

出版信息

Int Arch Otorhinolaryngol. 2024 Feb 5;28(3):e468-e472. doi: 10.1055/s-0043-1778015. eCollection 2024 Jul.

Abstract

The presence of foreign bodies in the airways remain a diagnostic challenge to healthcare professionals. They can become life threatening emergencies that require immediate intervention or go unnoticed for weeks and even months. Prevention is best but early recognition remains a critical factor in treatment of foreign body inhalation in children.  To study the diagnostic advantages of virtual over rigid bronchoscopy in the evaluation of children with suspected foreign body in the tracheobronchial tree and plan for early management.  A crossectional study conducted at a tertiary care hospital & medical college in India. A total 24 patients (0-12-years-old) who presented with complaints of sudden onset of coughing, choking, and breathing difficulty were included during the 2-year duration, from January 2018 to December 2019. All patients underwent virtual and rigid bronchoscopy.  In 8 patients, foreign bodies detected by virtual bronchoscopy were confirmed by rigid bronchoscopy. There was one case in which virtual bronchoscopy showed no foreign body, but rigid bronchoscopy detected it. In 15 cases virtual and rigid bronchoscopy did not show foreign bodies. The sensitivity, specificity, positive and negative predictive value of virtual bronchoscopy were 88.88, 100, 100, and 93.75%, respectively.  Virtual bronchoscopy is less invasive and does not require general anesthesia but cost and availability are limitations. It can be used as method of investigation in children with suspected foreign body aspiration.

摘要

气道内异物的存在对医护人员来说仍然是一个诊断难题。它们可能会成为危及生命的紧急情况,需要立即干预,也可能在数周甚至数月内未被察觉。预防是最好的办法,但早期识别仍然是儿童异物吸入治疗中的关键因素。

为研究在评估疑似气管支气管树异物的儿童时,虚拟支气管镜相对于硬质支气管镜的诊断优势,并规划早期治疗方案。

在印度一家三级护理医院和医学院进行了一项横断面研究。在2018年1月至2019年12月的两年期间,共纳入了24例(0至12岁)出现突发咳嗽、窒息和呼吸困难症状的患者。所有患者均接受了虚拟支气管镜和硬质支气管镜检查。

在8例患者中,虚拟支气管镜检测到的异物经硬质支气管镜证实。有1例虚拟支气管镜未显示异物,但硬质支气管镜检测到了异物。在15例病例中,虚拟支气管镜和硬质支气管镜均未显示异物。虚拟支气管镜的敏感性、特异性、阳性预测值和阴性预测值分别为88.88%、100%、100%和93.75%。

虚拟支气管镜侵入性较小,不需要全身麻醉,但费用和可用性是其局限性。它可作为疑似异物吸入儿童的一种检查方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cbf7/11226272/7089ac233389/10-1055-s-0043-1778015-i2023041527or-1.jpg

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