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耳鼻喉科异物复杂病例:病例系列

Complicated cases in foreign bodies of the ear, nose, and throat: a case series.

作者信息

Srivanitchapoom Chonticha, Yata Kedsaraporn

机构信息

Phayao Hospital, Otolaryngology unit, Phayao, Thailand Phayao Hospital Otolaryngology unit Phayao Thailand.

出版信息

Colomb Med (Cali). 2024 Jun 30;55(2):e2045837. doi: 10.25100/cm.v55i2.5837. eCollection 2024 Apr-Jun.

Abstract

BACKGROUND

Managing foreign bodies in otorhinolaryngology requires appropriate treatment based on case severity.

OBJECTIVE

To analyze the clinical characteristics associated with complicated cases of foreign bodies.

METHODS

This study categorized patients with diagnosed foreign bodies into complicated and uncomplicated cases. Complicated cases were defined as complications from foreign bodies requiring an operating room procedure, hospitalization, or tracheal foreign body. Otherwise, they were considered uncomplicated. Clinical data and disease variables were recorded. Univariate and multivariate regression analyses were performed to evaluate the significance of different clinical features between the groups (-value <0.05).

RESULTS

Of the 751 cases studied, most cases involving foreign bodies were treated outpatient and typically presented without complications, while 20.1% (n=151) were confirmed as complicated. There were 119 cases present with complications from foreign bodies, 58 requiring removals in an operating room, 57 needing hospitalization, and two tracheal foreign bodies. Multivariate analysis revealed that male gender (-value 0.043, OR (95%CI) = 1.554 (1.015-2.378)), positive presenting symptoms (-value <0.0001, OR (95%CI)= 4.081 (2.299-7.248)), foreign body in the hypopharyngeal area (-value <0.0001, OR (95%CI) = 65.615 (6.907-623.336)), and foreign body in the laryngeal area (-value 0.006, OR (95%CI) = 27.787 (2.568-300.673)) were significantly associated with complicated foreign bodies cases.

CONCLUSION

Complicated foreign body cases should be addressed in male patients complaining of symptoms and foreign bodies in the hypopharyngeal and laryngotracheal locations. Due to the complexity of their condition, effective management of these patients requires a multidisciplinary approach.

摘要

背景

耳鼻喉科异物处理需要根据病例严重程度进行适当治疗。

目的

分析异物复杂病例的临床特征。

方法

本研究将诊断为异物的患者分为复杂病例和非复杂病例。复杂病例定义为因异物导致需要手术室手术、住院治疗或气管异物等并发症。否则,视为非复杂病例。记录临床数据和疾病变量。进行单因素和多因素回归分析以评估两组间不同临床特征的显著性(P值<0.05)。

结果

在研究的751例病例中,大多数异物病例为门诊治疗且通常无并发症,而20.1%(n = 151)被确认为复杂病例。有119例存在异物并发症,58例需要在手术室取出,57例需要住院,2例为气管异物。多因素分析显示,男性(P值0.043,OR(95%CI)= 1.554(1.015 - 2.378))、有阳性症状(P值<0.0001,OR(95%CI)= 4.081(2.299 - 7.248))、下咽区异物(P值<0.0001,OR(95%CI)= 65.615(6.907 - 623.336))以及喉区异物(P值0.006,OR(95%CI)= 27.787(2.568 - 300.673))与复杂异物病例显著相关。

结论

对于有症状且异物位于下咽和喉气管部位的男性患者,应处理复杂异物病例。由于病情复杂,对这些患者进行有效管理需要多学科方法。

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