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儿童气道消化道异物:管理中的陷阱

Aerodigestive-tract foreign bodies in children: pitfalls in management.

作者信息

Papsin B C, Friedberg J

机构信息

Department of Otolaryngology, Hospital for Sick Children, Toronto, Ontario.

出版信息

J Otolaryngol. 1994 Apr;23(2):102-8.

PMID:8028067
Abstract

A review of the charts of pediatric patients admitted with the final diagnosis of tracheobronchial or esophageal foreign bodies was carried out for the 5 years prior to September 30, 1992. Removal of foreign bodies from the aerodigestive tract poses little problem for the experienced endoscopist, and the inference that the diagnosis and initial management of patients should be equally well performed often follows. However, initial misdiagnosis, delayed diagnosis, inappropriate methods of patients transfer, or great variation in diagnosis methods still provide ample opportunity for delay in treatment and complication. Pitfalls in management occurred because of incomplete radiographic evaluation, confusion due to prior or concurrent illness, improper patient transfer, unusual presentation, and inappropriate methods of foreign-body removal. Demonstrative cases and summary statistics are presented.

摘要

对1992年9月30日前5年期间最终诊断为气管支气管或食管异物而入院的儿科患者病历进行了回顾。对于经验丰富的内镜医师来说,从气道消化道取出异物几乎没有问题,并且常常会得出患者的诊断和初始治疗也应同样出色的推断。然而,初始误诊、延迟诊断、不恰当的患者转运方法或诊断方法的巨大差异,仍然为治疗延误和并发症提供了充足的机会。管理上的失误是由于影像学评估不完整、既往或并发疾病导致的混淆、患者转运不当、表现不寻常以及异物取出方法不当。文中展示了一些典型病例和汇总统计数据。

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