影响呼吸道异物患儿异物取出术前发生ARD的相关因素分析  

Analysis on the correlated risk factors responsible for ARD before removal operation in children with foreign body in respiratory tract

作　　者：陶礼华[1] 黄敏[1] TAO Lihua HUA NG Min(Hunan Provincial Children＇s Hospital, Changsha, 410007, China)

机构地区：[1]湖南省儿童医院,长沙410007

出　　处：《中国中西医结合耳鼻咽喉科杂志》2016年第6期450-452,449,共4页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的探讨呼吸道异物患儿异物取出术前发生急性呼吸功能不全(acute respiratory dysfunction,ARD)的相关危险因素。方法回顾性分析我院2013年1月至2015年3月期间收治的468例呼吸道异物患儿,收集所有患儿的一般资料,异物史与既往病史,异物存留部位、异物种类等临床资料,是否有肺炎、发热、纵隔或皮下积气等并发症,术前体温和心率、呼吸频率、紫绀情况、血气分析以及经皮氧饱和度等监测数据,利用Logistic回归分析可能引起患儿急性呼吸功能不全的相关危险因素。结果本组患儿出现ARD者84例(17.9%,84/468)。Logistic回归分析显示,术前存在纵隔或皮下积气、合并肺炎以及异物位于患儿双侧支气管或气管,均是出现ARD的独立危险因素(均P<0.05)。结论术前纵隔或皮下积气、合并肺炎、异物位于双侧支气管或主气管,是呼吸道异物患儿异物取出术前发生ARD的独立危险因素,早期判断相关危险因素,能够为临床治疗提供较为可靠的参考依据。Objective To investigate the correlated risk factors responsible for development of acute respiratory dysfunction（ARD） before foreign body removal operation among children with foreign body in respiratory tract based on a cases analysis. Method A retrospective study was carried out among 468 children cases with foreign bodies in their respiratory tract and treated in our Hospital from Jan., 2013 to Mar., 2015. Their clinical records were collected and analyzed carefully, including such data as general information（age and gender）, ill history, past medical records, the locations of foreign bodies remaining and the types of foreign bodies, whether or not there being such complications present as pneumonia, fever, mediastinal or subcutaneous emphesema, their preoperative temperature, heart rate, breathing rate, the severity of cyanosis, as well as such data as blood gas analysis and transcutaneous oxygen saturation monitoring. Then, Logistic regression analysis was taken to explore the possibly correlated risk factors to induce ARD developing before foreign body removal procedures among them. Result ARD was taken place in 84 cases in this group of children patients, with an incidence of 17.9%（84/468）. As shown from Logistic regression analysis, the most possibly correlated risk factors with ARD attacking included preoperatively presented mediastinal or subcutaneous emphesema, complicated pneumonia, and remained foreign bodies in bilateral bronchus or trachea, all being independent risk factors responsible for ARD（P〈0.05）. Conclusion The most possibly correlated risk factors with ARD attacking among children cases with foreign bodies in respiratory tract may be preoperatively presented mediastinal or subcutaneous emphesema, complicated pneumonia and foreign bodies remaining in bilateral bronchus or trachea, all being independent risk factors responsible for developing of such a condition before surgical removal. Early assessment of such risk factors in this kind of cases can provide as reliable as p

关 键 词：呼吸道异物 儿童 急性呼吸功能不全 相关危险因素 并发症 

分 类 号：R726.5[医药卫生—儿科]