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目的探讨儿童喉、气管异物的临床特点及诊治手段。方法分析2001年1月到2005年6月间经硬质气管镜或纤维支气管镜确诊的87例喉、气管异物患儿的临床特点、影像学改变、并发症、异物取除方法。结果气管、喉异物占同期呼吸道异物的10.7%(87813),1～3岁组占73.6%。93.1%有异物吸入史,喘鸣占67.8%、吸气性凹陷40.2%、发绀27.6%、声音嘶哑19.5%、气管拍击音4.6%。6例(6.9%)患儿病情突变,表现发绀、呼吸困难,神志不清。胸片异常30.2%,胸透异常26.5%。硬质气管镜取异物63例并全部取出(100%),其中3例为纤支镜取异物未成功者;纤支镜取异物20例,取出17例(85.0%),两者成功率差异无显著性(P>0.5),但纤支镜取异物耗时不确定,并有5例异物通过鼻后孔时跌落入食道。结论儿童喉、气管异物典型症状不多见,异物吸入史为敏感指标;胸片、胸透异常率低,应及时作纤支镜检查,取除喉、气管异物首选硬质气管镜。
Objective To investigate the clinical features and diagnosis and treatment of larynx and tracheal foreign body in children. Methods From January 2001 to June 2005, 87 patients with throat and tracheal foreign body diagnosed by rigid bronchoscope or bronchofibroscopy were retrospectively analyzed. The clinical features, imaging changes, complications and removal of foreign bodies were analyzed. Results The tracheal and throat foreign bodies accounted for 10.7% (87813) of the foreign body in the same breath, while the group of 1 to 3 years old accounted for 73.6%. 93.1% had history of foreign body inhalation, 67.8% of wheezing, 40.2% of aspiration pits, 27.6% of cyanosis, 19.5% of hoarseness, and 4.6% of trachea. 6 cases (6.9%) children with sudden changes in the performance of cyanosis, dyspnea, confusion. Abnormal chest X-ray 30.2%, 26.5% abnormal chest X-ray. 63 cases of foreign bodies were removed by hard bronchoscopy and all of them were removed (100%), of which 3 cases were unsuccessful with fiberoptic bronchoscopy, 20 cases with foreign body by fiberoptic bronchoscopy and 17 cases (85.0%) with bronchoscopy, the difference between the two No significant (P> 0.5), but the time-consuming foreign body bronchoscopy take time uncertainty, and 5 foreign body drops through the posterior orifice of the nose into the esophagus. Conclusion The typical symptoms of foreign bodies in the larynx and trachea are rare and the history of foreign body aspiration is sensitive. The abnormal rate of chest radiograph and thoracic radiography should be shortened. Fiberoptic bronchoscopy should be performed in time to remove throat and tracheal foreign body.