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目的探讨儿童气管支气管异物的临床特征。方法回顾性分析天津市儿童医院2011年6月至2016年6月行支气管镜诊断和治疗的84例气管支气管异物患儿的一般情况、吸入史、病程、异物种类、异物滞留部位、临床表现及影像学特征。结果儿童气管支气管异物好发于男童(男∶女为2.23∶1),主要发病年龄为6个月至3岁(89.29%),患儿居住地农村多于城市(城市30.95%,农村69.05%),尤以农村男童为高发人群(P<0.05)。能够准确提供异物吸入病史有助于早期确诊及治疗(P<0.05)。吸入异物种类以可食性异物为主,以坚果类多见。气管支气管异物滞留于左、右主支气管的比例差别不大,但滞留于右侧叶支气管病例数多于左侧。不同的气道滞留部位所引起的临床症状有区别。最常见症状为咳嗽(98.81%)和喘息(58.33%),影像学有肺气肿(55.95%)表现。结论气管支气管异物重点防控对象为农村3岁以下的男童,应加强监护人对于气管支气管异物的重视,减少幼儿对坚果类食物的接触。对于反复咳嗽、喘息、查体单侧呼吸音减弱,影像学伴有肺气肿、肺不张的患儿,应重视异物吸入史或呛咳史,积极行支气管镜检查以明确诊断及治疗。
Objective To investigate the clinical characteristics of children with tracheobronchial foreign body. Methods The clinical data of 84 children with tracheobronchial foreign bodies diagnosed and treated with bronchoscopy from June 2011 to June 2016 in Tianjin Children’s Hospital were retrospectively analyzed. The history, history, types of foreign bodies, foreign body retention sites, clinical manifestations, Imaging features. Results Children with tracheobronchial foreign body occurred in boys (male: female: 2.23:1), with the main onset age ranging from 6 months to 3 years (89.29%). Children living in rural areas were more than urban ones (30.95% in urban areas and 69.05 in rural areas %), Especially for rural boys as high risk group (P <0.05). Being able to accurately provide history of foreign body aspiration is helpful for early diagnosis and treatment (P <0.05). Inhalation of foreign body species mainly edible foreign body, mostly nuts. There was no significant difference in the proportion of tracheobronchial foreign bodies in the left and right main bronchi, but the number of bronchi in the right lobes was more than the left ones. Different parts of the airway caused by the clinical symptoms are different. The most common symptoms were cough (98.81%) and wheezing (58.33%), imaging of emphysema (55.95%). Conclusion The main target of prevention and control of tracheobronchial foreign body is the boy below 3 years of age in rural areas. Caregivers should pay more attention to tracheobronchial foreign body and reduce their contact with nutty food. For repeated coughing, wheezing, examination of unilateral breath sounds weakened, imaging associated with emphysema, atelectasis in children should pay attention to the history of foreign body inhalation or choking, and actively bronchoscopy to confirm the diagnosis and treatment.