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[儿童支气管异物的肺科问题。100例经验]

[Pneumological aspects of bronchial foreign bodies in children. Experience with 100 cases].

作者信息

Khiati M, Couvreur J, Grimfeld A, Le Moing G, Tournier G

出版信息

Rev Pneumol Clin. 1984;40(4):221-6.

PMID:6545462
Abstract

100 cases of bronchial foreign body seen over a period of 4 years represent 1.2% of the admissions of a paediatric pneumology unit; 73% of the children were aged between 6 months and 3 years. The foreign body was vegetable in 61% of cases (a peanut in 44% of cases). The time between the inhalation and the endoscopic diagnosis was greater than 7 days in 70% of cases and greater than 30 days in 37% of cases. Removal of the foreign body was possible in all but one case. In particular, the authors studied the pneumological implications of a foreign body: the value of a quantitative bacteriological study of the bronchial secretions, which was significant in 43% of cases, and detection of the sequelae by prospective clinical and functional surveillance with a follow-up of 3 to 24 months. After 6 months, persistent radiological abnormalities were found in 40% of cases, perfusion disorders were found in 35% and ventilation disorders were found in 64%. A surgical operation was performed in 7 cases: one case of bronchotomy for extraction of the foreign body and 6 cases of parenchymal excision, including 2 total pneumonectomy for a destroyed lung. These were no death. The pathophysiology of the complications of functional disorders and of dilatation of the bronchi is discussed in the context of the experience gained from this series.

摘要

在4年期间所见的100例支气管异物占小儿肺病科住院病例的1.2%;73%的患儿年龄在6个月至3岁之间。61%的病例异物为植物性(44%的病例为花生)。70%的病例吸入异物至内镜诊断的时间超过7天,37%的病例超过30天。除1例外,所有病例的异物均成功取出。特别是,作者研究了异物的肺部影响:支气管分泌物定量细菌学研究的价值,43%的病例结果具有显著性,并通过前瞻性临床和功能监测对后遗症进行检测,随访时间为3至24个月。6个月后,40%的病例存在持续性放射学异常,35%存在灌注障碍,64%存在通气障碍。7例进行了手术:1例为支气管切开取异物,6例为实质切除,其中2例因肺毁损行全肺切除术。无死亡病例。结合本系列病例所获经验,讨论了功能障碍并发症及支气管扩张的病理生理学。

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