成人气管支气管异物插管:25年的经验

B. Altuntas, Y. Aydın, A. Eroğlu
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引用次数: 2

摘要

目的:成人气管支气管异物吸入的发生率低于儿童。在本文中,我们旨在介绍我们25年来成人气管支气管异物吸入的经验。方法:选取1990年1月至2015年1月期间122例16岁以上疑似气管支气管异物吸入患者。根据患者的年龄、性别、临床症状和体格检查结果、异物的定位和类型、放射学表现和治疗方案对患者的数据卡进行回顾性评估。结果:女性96例(78.7%),男性26例(21.3%)。年龄17 ~ 70岁,平均30.3岁。所有患者均行刚性支气管镜检查。异物112例(91.8%)。采用刚性支气管镜取出异物109例。其余3例均行开胸和气腹手术。最常见的异物是针(83%)。主要症状为咳嗽(100%)。异物最常见的解剖位置为右支气管系统(60.7%)。主要影像学表现为相关异物不透像(88.4%)。2例患者因支气管扩张而行右下肺叶切除术。结论:气管支气管异物进气道如不及早治疗,可在晚年发生不可逆的化脓性肺部疾病。社会对这一主题的教育是减少气管支气管异物吸入频率的主要预防措施。
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Tracheobronchial Foreign Bodies Aspirations in Adults: A 25-Years Experience
Objective:The incidence of tracheobronchial aspirations of foreign bodies in adults is lower than in children. In this article, we aimed to present our experience in tracheobronchial aspiration of foreign bodies in adults during 25-years.Methods:From January 1990 to January 2015, 122 patients older than 16 years with suspected tracheobronchial aspiration of foreign body were included in this study. Patients’ data cards were retrospectively assessed according to age, gender, clinical symptoms and physical examination findings, localization and type of foreign body, radiologic findings and therapeutic options.Results:Ninety-six of the patients were female (78.7%) and 26 were male (21.3%). The age range was 17-70 years and mean age was 30.3 years. Rigid bronchoscopy was performed in all patients. Foreign bodies were seen in 112 patients (91.8%). Foreign bodies were extracted by rigid bronchoscopy in 109 patients. Thoracotomy and pneumotomy were performed in the remaining 3 patients. The most common foreign body was pin (83%). The chief symptom was cough (100%). The most common anatomic location of foreign bodies was right bronchial system (60.7%). The main radiologic finding was radiopaque image of the related foreign body (88.4%). Right lower lobectomy was performed in two patients because of bronchiectasis.Conclusion:If tracheobronchial aspirations of foreign bodies are not treated in early period, irreversible and suppurative lung diseases may occur as results of aspirations in later years. The education of societies about this subject is principal precaution in reducing the frequency of tracheobronchial aspirations of foreign bodies.
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