Wolach B, Raz A, Weinberg J, Mikulski Y, Ben Ari J, Sadan N
Department of Pediatrics, Meir General Hospital, Kfar Saba, Israel.
Int J Pediatr Otorhinolaryngol. 1994 Jul;30(1):1-10. doi: 10.1016/0165-5876(94)90045-0.
During 10 years, 127 children were admitted to the pediatric ward because of aspiration of foreign bodies (0.56% of all admissions). Eighty-one percent of the children were under 3 years of age. One hundred and one children (80%) had a positive history of foreign body aspiration. Vegetable substances, particularly peanuts and grains, were the commonest type of foreign body removed. Clinical signs and radiological studies were, in most children, pathognomonic, but sometimes not conclusive. Chest X-rays were normal in 18%; fluoroscopy was diagnostic in 92%. Rigid bronchoscopy and subsequent removal of the foreign body was the treatment instituted. Pneumonia (the commonest complication) developed before and after bronchoscopy in 28% of the children. Pneumomediastinum and subcutaneous emphysema were present on admission in 2 children. Cardiac arrhythmias, bronchospasm, and cardiac arrest were recorded during bronchoscopy. Bronchiectasis developed in one, and persistent intractable pneumonia, requiring lobectomy, developed in another patient. One death occurred.
在10年期间，127名儿童因异物吸入被收治于儿科病房（占所有住院病例的0.56%）。81%的儿童年龄在3岁以下。101名儿童（80%）有异物吸入史。植物性物质，尤其是花生和谷物，是最常见的被取出的异物类型。在大多数儿童中，临床体征和影像学检查具有特征性，但有时并不具有决定性。18%的儿童胸部X线检查正常；透视检查的诊断率为92%。采用硬质支气管镜检查并随后取出异物进行治疗。28%的儿童在支气管镜检查前后发生肺炎（最常见的并发症）。2名儿童入院时存在纵隔气肿和皮下气肿。支气管镜检查期间记录到心律失常、支气管痉挛和心脏骤停。1例发生支气管扩张，另1例患者发生持续性难治性肺炎，需要进行肺叶切除术。发生1例死亡。
