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管理声门下异物的挑战与考量

Challenges and Considerations in Managing Subglottic Foreign Bodies.

作者信息

Agarwall Shruti, Das Sauradeep, Balakrishnan Manu Coimbatore, Chakraborty Suvamoy

机构信息

Department of Otorhinolaryngology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, 793018 India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2025 May;77(5):2206-2210. doi: 10.1007/s12070-025-05484-7. Epub 2025 Apr 22.

Abstract

Advancements in endoscopy, anaesthesia, radiology, and surgical techniques have reduced paediatric airway foreign body mortality. Despite this, children aged 0-3 years are particularly susceptible to airway obstructions due to immature swallowing coordination and inability to distinguish edible from non-edible items. Foreign body aspiration often presents with coughing, wheezing, and respiratory distress but can be challenging to diagnose without a witnessed event. This case report describes a 16-month-old who aspirated a pork bone, requiring tracheostomy and emergency bronchoscopy. Foreign body was successfully removed from the subglottic region using a paediatric bronchoscope. Subglottic foreign bodies, though rare, pose significant risks. Prompt intervention, proper training, and effective team coordination are crucial for successful management and preventing complications.

摘要

内镜检查、麻醉、放射学及外科技术的进步降低了小儿气道异物的死亡率。尽管如此,0至3岁的儿童由于吞咽协调功能不成熟以及无法区分可食用与不可食用物品,特别容易发生气道阻塞。异物吸入常表现为咳嗽、喘息和呼吸窘迫,但如果没有目睹事件,诊断可能具有挑战性。本病例报告描述了一名16个月大的儿童吸入了一块猪骨,需要进行气管切开术和紧急支气管镜检查。使用小儿支气管镜成功地从声门下区域取出了异物。声门下异物虽然罕见,但风险很大。及时干预、适当培训和有效的团队协作对于成功处理和预防并发症至关重要。

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本文引用的文献

1
Pediatric Airway Foreign Bodies and Their Management by Rigid Bronchoscopy: How I Experienced.小儿气道异物及其硬质支气管镜治疗:我的亲身经历
Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):6422-6437. doi: 10.1007/s12070-020-01868-z. Epub 2020 May 25.
4
Paediatric inhaled airway foreign bodies: An update.儿科吸入性气道异物:更新。
Aust J Gen Pract. 2019 Apr;48(4):171-174. doi: 10.31128/AJGP-11-18-4768.
5
Rigid Bronchoscopy in Pediatric Patients.小儿患者的硬质支气管镜检查
Indian J Otolaryngol Head Neck Surg. 2017 Dec;69(4):449-452. doi: 10.1007/s12070-017-1222-2. Epub 2017 Oct 13.
7
Foreign body injuries in children: a review.儿童异物损伤:综述
Acta Otorhinolaryngol Ital. 2015 Oct;35(4):265-71.
10
Tracheobronchial foreign bodies.气管支气管异物
Chest Surg Clin N Am. 2001 Nov;11(4):861-72.

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