Hoeve L J, Rombout J, Pot D J
Department of Otorhinolaryngology, Sophia Children's Hospital, Rotterdam, The Netherlands.
Clin Otolaryngol Allied Sci. 1993 Feb;18(1):55-7. doi: 10.1111/j.1365-2273.1993.tb00810.x.
One hundred and fifteen patients, between 6 months and 12 years of age, had bronchoscopy on suspicion of foreign body aspiration. The histories of these patients were studied to examine the diagnostic value of signs, symptoms and examinations, and to determine the time that passed between aspiration and removal of the foreign body. The sensitivity of the symptoms choking and coughing was fairly high (81 and 78%), but the specificity was poor. The sensitivity of a chest radiograph was 82%, the specificity 44%. The sensitivity of radiographs on inspiration and expiration was 80%, the specificity 55%. The patients had been referred with the initial diagnosis foreign body aspiration (80), pneumonia (34), or subglottic laryngitis (1). In 85 patients a foreign body was identified and extracted. The other 30 patients had respiratory tract infections. The initial diagnosis of foreign body aspiration was correct in 61 out of 85 patients. In these cases, the period between aspiration and extraction of the foreign body was a mean 6 days, compared with 55 days, if the initial diagnosis was pneumonia or sub-glottic laryngitis. We conclude that the diagnosis of foreign body aspiration is too often missed, and that, apart from bronchoscopy, diagnostic tools are of little value.
115名年龄在6个月至12岁之间的患者因怀疑有异物吸入而接受了支气管镜检查。对这些患者的病史进行了研究，以检查体征、症状和检查的诊断价值，并确定异物吸入与取出之间的时间间隔。窒息和咳嗽症状的敏感性相当高（分别为81%和78%），但特异性较差。胸部X光片的敏感性为82%，特异性为44%。吸气和呼气时X光片的敏感性为80%，特异性为55%。这些患者最初的诊断为异物吸入（80例）、肺炎（34例）或声门下喉炎（1例）。85例患者发现并取出了异物。其他30例患者患有呼吸道感染。85例患者中有61例异物吸入的初步诊断正确。在这些病例中，异物吸入与取出之间的平均时间为6天，而如果初步诊断为肺炎或声门下喉炎，则为55天。我们得出结论，异物吸入的诊断常常被漏诊，而且除了支气管镜检查外，诊断工具价值不大。
