Cohen S R, Herbert W I, Lewis G B, Geller K A
Ann Otol Rhinol Laryngol. 1980 Sep-Oct;89(5 Pt 1):437-42. doi: 10.1177/000348948008900513.
The charts of 143 patients with foreign bodies in the larynx and tracheobronchial tree who were admitted to the Chidrens Hospital of Los Angeles during the period 1973 to 1978 were reviewed. Of these children 84 were male and 59 were female. One hundred were private patients and forty-three were clinic patients. Of these foreign bodies 60 were nut meat which is by far the most common foreign body of the tracheobronchial tree. All foreign bodies were successfully removed. One hundred twenty-six were discharged within the first 24 hours after admission and treatment. Fifty-one or 36% of these patients were discharged on the same day after the foreign body was removed. Sixty-two of the foreign bodies were in the left bronchial tree, while 55 were in the right bronchial tree. One hundred thirty-eight were endoscoped under general anesthesia using the apneic technique and five patients were treated with oxygen standby only because of severe respiratory obstruction. A detailed description of the use of apneic technique with profound muscle relaxation, the avoidance of preoperative medication and the team approach to ventilating the patients are all described. The advantage of general anesthesia, and the potential intraoperative and postoperative problems are reviewed. Of the total number of cases 13% were between 4 and 11 months of age, 44% were between 12 and 23 months of age and 57% were over 23 months of age.
回顾了1973年至1978年期间入住洛杉矶儿童医院的143例喉及气管支气管树异物患者的病历。这些儿童中，84例为男性，59例为女性。100例为自费患者，43例为门诊患者。这些异物中，60例为坚果仁，是气管支气管树中迄今为止最常见的异物。所有异物均成功取出。126例患者在入院和治疗后的头24小时内出院。其中51例（36%）在异物取出后的同一天出院。62例异物位于左支气管树，55例位于右支气管树。138例患者在全身麻醉下采用窒息技术进行内镜检查，5例患者仅因严重呼吸阻塞采用氧气备用治疗。详细描述了采用深度肌肉松弛的窒息技术、避免术前用药以及团队为患者通气的方法。回顾了全身麻醉的优点以及潜在的术中及术后问题。病例总数中，13%的患者年龄在4至11个月之间，44%的患者年龄在12至23个月之间，57%的患者年龄超过23个月。
