小儿气道异物围术期并发症与异物留存时间的关系  

The relationship between duration of admittance and incidence of complications in tracheobronchial foreign body in children

作　　者：陈丹[1] 李绍清[1] 刘宇琦[1] 陈莲华[1] 

机构地区：[1]复旦大学附属眼耳鼻喉科医院麻醉科,上海200031

出　　处：《复旦学报（医学版）》2010年第4期483-486,共4页Fudan University Journal of Medical Sciences

摘　　要：目的探讨小儿气道异物围术期并发症与异物留存时间的关系。方法气道异物患儿304例,年龄5个月~12岁,ASAⅠ或Ⅱ级,按异物留存时间分成3组:A组为异物留存时间≤24 h;B组为异物留存时间24 h^7天;C组为异物留存时间>7天。观察术前合并肺炎,术中或苏醒期低氧血症,及苏醒期喉痉挛的发生情况。结果术前合并肺炎发生率A组低于B、C组,B组低于C组(P<0.05);苏醒期喉痉挛发生率B、C组均高于A组(P<0.05),B组和C组间差异无统计学意义(P>0.05);A、B、C三组间在术中和苏醒期低氧血症发生率差异无统计学意义(P>0.05)。结论异物留存时间长短与肺部并发症、苏醒期喉痉挛的发生率呈正相关;对于气道异物患儿,24 h内能明确诊断治疗可以减少并发症发生。Objective To explore the relationship between the time of admittance and the incidence of complications in paediatric foreign body. Methods Three hundred and four children aged 5 months to 12 years,ASAⅠ or Ⅱ grade,undergoing emergency operation of airway foreign body removal were included in this study.According to the time of admittance,cases were assigned into 3 groups： within the first 24 hours（A）,24 h-7 days（B）,more than 7 days（C）.The complications such as pneumonia before operation,laryngospasm and hypoxemia during and after the operation were observed and recorded. Results The incidence of pneumonia before the operation was higher in group B and C than in group A,and lower in group B than in group C（P0.05）.The incidence of laryngeal spasm during emergence stage was higher in group C than in group A and B（P0.05）.There was no difference among the three groups in the incidence of hypoxemia during the operation（P0.05）. Conclusions The incidence of pulmonary complications were related to foreign body admittance,and when the foreign body remained more than 24 hours,the incidence increased.It is advisable to perform bronchoscopy in the early stage of all suspected cases to avoid serious complications.

关 键 词：气道异物 留存时间 并发症 儿童 

分 类 号：R768.13[医药卫生—耳鼻咽喉科]