经纤维支气管镜应用螺旋形取石网篮摘除儿童支气管异物的临床效果  

Effect of spiral stone removal net basket under fiberoptic bronchoscope on bronchial foreign bodies in children

作　　者：孙兴珍[1] 洪泽[1] 胡剑[1] 李加新[1] 孙素华[2] Sun Xingzhen;Hong Ze;Hu Jian;Li Jiaxin;Sun Suhua(Department of Pediatrics,the Affiliated Huaian First People’s Hospital of Nanjing Medical University,Huaian 223300,China;Endoscopy Center,the Affiliated Huaian First People’s Hospital of Nanjing Medical University,Huaian 223300,China)

机构地区：[1]南京医科大学附属淮安第一医院儿科,223300 [2]南京医科大学附属淮安第一医院内镜中心,223300

出　　处：《中国实用医刊》2020年第16期21-24,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨经纤维支气管镜应用螺旋形取石网篮摘除儿童支气管异物的疗效及安全性。方法抽取2017年1月至2019年3月南京医科大学附属淮安第一医院收治的支气管异物患儿96例,均行经纤维支气管镜应用螺旋形取石网篮摘除异物,回顾性分析其临床资料,统计异物的支气管镜下表现、种类。结果 96例患儿支气管镜下见支气管均被完全或部分阻塞,局部黏膜充血肿胀,75例(78.1%)有明显肉芽增生包裹;28例(29.2%)异物取出后行支气管肺泡灌洗时,见深部支气管黏膜肿胀糜烂,较多分泌物附着。异物以固体或易破碎的果仁类为主,以花生最多。异物嵌顿部位:右侧支气管50例(52.1%),左侧支气管44例(45.8% ),双侧支气管2例(2.1% ),异物沉积在右侧者略高于左侧。96例均成功摘除异物,未见严重不良反应和并发症。结论经纤维支气管镜应用螺旋形取石网篮摘除儿童支气管异物是一种安全、有效的方法。Objective To investigate the efficiency and safety of spiral stone-net basket under fiberoptic bronchoscope for removal on bronchial foreign bodies in children.Methods Ninety-six children with bronchial foreign bodies admitted to the Affiliated Huaian First Hospital of Nanjing Medical University from January 2017 to March 2019 were selected.All patients were treated with spiral stone removal net basket under fiberoptic bronchoscope was used to remove foreign bodies.The clinical data were retrospectively analyzed and the bronchoscopy performance and types of foreign bodies were counted.Results Bronchoscopy showed that 96 children were complete or partial obstruction of bronchi,congestion and swelling of local mucosa in 75 cases(78.1%)with obvious granulation hyperplasia,in 28 cases(29.2%)after removal of foreign bodies,bronchoalveolar lavage revealed deep bronchial mucosa swelling and erosion,with more secretions attached.The main foreign bodies were solid or fragile kernels,most of which were peanuts.Fifty cases(52.1%)were located in the right bronchus,44 cases(45.8%)in the left bronchus and 2 cases(2.1%)in the bilateral bronchus.The foreign bodies deposited in the right bronchus were slightly higher than in the left bronchus.All 96 cases of foreign bodies were successfully removed without serious adverse reactions and complications.Conclusions Due to the advantages of safety,good effectiveness and minimal invasion,the spiral stone-net basket technigue under fiberoptic bronchoscope is favorable in removal of bronchial foreign bodies in children.

关 键 词：纤维支气管镜 螺旋形取石网篮 支气管异物 儿童 

分 类 号：R725.6[医药卫生—儿科]