成人支气管异物三例报告并文献复习  

Bronchial Foreign Body in Adults: Three Cases Report and Literatures Review

作　　者：苏奕亮[1] 周瑛[1] 李秋红[1] 张芬[1] 沈瓅 胡洋[1] 张苑[1] 李惠萍[1] 

机构地区：[1]同济大学附属上海市肺科医院呼吸科,上海200433

出　　处：《中国呼吸与危重监护杂志》2016年第5期484-489,共6页Chinese Journal of Respiratory and Critical Care Medicine

基　　金：上海市卫生和计划生育委员会青年科研课题(20134Y046 20124Y101)

摘　　要：目的提高对成人支气管异物的认识。方法对3例成人支气管异物患者的临床资料进行整理分析,并结合相关文献进行复习。结果 3例患者异物均在右侧支气管,1例初诊右肺肿瘤,1例初诊右肺炎症,1例初诊右侧支气管异物。3例患者均未主动提供误吸史,最终均通过气管镜检查明确诊断并取出异物,其中有1例行2次气管镜检查。检索国内外文献978篇,报道成人支气管异物2 920例,75.00%患者未主动提供异物吸入史;80.13%患者在行气管镜检查前被误诊为其他疾病,包括肺炎(31.23%)、肺癌(25.21%)、肺结核(5.81%)、支气管扩张(6.58%)、支气管哮喘(12.47%)等呼吸系统疾病,有些误诊长达30余年。结论成人支气管异物较易误诊,气管镜对支气管异物的诊断治疗起重要作用。Objective To highlight the characteristics of bronchial foreign body in Aduhs. Methods The clinical data of three patients with bronchial foreign body were analyzed and related literatures were reviewed. Results Foreign bodies in three patients were all located in right bronchi. Their initial diagnoses were tumor, pneumonia and foreign body, respectively. They all didn＇t offer a definite history of foreign body aspiration. Foreign bodies in three patients were diagnosed and treated by bronchoscopy. Through reviewing 978 related literatures, we found 2920 cases of bronchial foreign body in adults. 75.00% of them didn＇ t offer a history of foreign body aspiration. 80. 13% of them were misdiagnosed as other diseases before bronchoscopy, such as pneumonia（ 31.23% ）, lung cancer（25.21% ）, tuberculosis （5.81% ）, bronchiectasis （6. 58% ） and asthma （ 12.47% ）. Some of them were misdiagnosed for over 30 years. Conclusions Bronchial foreign bodies in adults are easily misdiagnosed. Bronchoscopy plays an important role in diagnosis and treatment of bronchial foreign body.

关 键 词：支气管异物 气管镜 成人 

分 类 号：R768.13[医药卫生—耳鼻咽喉科]